Tu&Dy;K.Kdkjh ;Kstukvksa Dk Laxzg

tu&dY;k.kdkjh ;kstukvksa dk laxzg ¼ijkfof/kd Lo;a lsodksa ds fy, ekxZnf’kZdk½

gfj;k.kk jkT; fof/kd lsok izkf/kdj.k çdk’kd% gfj;k.kk jkT; fof/kd lsok izkf/kdj.k bfULVVw’kuy IykV uEcj 9] lSDVj-14] iapdqyk bZ&esy % [email protected] oSc lkbZV % www.hslsa.nic.in rkfydk Øe ;kstuk,¡ ist uEcj la[;k 1. o`)koLFkk lEeku HkÙkk ;kstuk 1-5 2. fo/kokvksa vkSj cslgkjk vkSjrksa ds fy, gfj;k.kk ljdkj iSa’ku 6-10 ;kstuk ¼fo/kok iSa’ku½ 3. gfj;k.kk fodykax O;fDr iSa’ku ;kstuk ¼fodykax iSa’ku½ 11-15 4. gfj;k.kk ljdkj dh ykMyh lkekftd lqj{kk HkÙkk ;kstuk 16-20 5. ckSuk HkÙkk ;kstuk 21-23 6. fdUuj ¼fgtM+k½ HkÙkk ;kstuk 24-26 7. fujkfJr cPpksa dks foÙkh; lgk;rk ;kstuk 27-31 8. gfj;k.kk Je dY;k.k cksMZ }kjk lapkfyr Je dY;k.k ;kstuk,a 32-35 9. jk'ku dkMZ 36-50 10. ikuh dk duSD’ku 51-54 11. fctyh duSD’ku 55-75 12. LFkkbZ fuokl izek.k i= 76-79 13. xzkeh.k {ksf=; izek.k i= 80-82 14. vuqlwfpr tkfr izek.k i= 83-86 15. fiNM+h Js.kh tkfr dk izek.k i= 87-90 16. vfrfjDr fiNM+h Js.kh tkfr dk izek.k i= 91-96 17. Vijhokt o foeqDr tkfr ls lacaf/kr cPpksa ds fy, izek.k i= 97-99 18. vk;q dk izek.k i= 100-101 19. vk; izek.k i= 102-105 20. ukxfjd vf/kdkj i= 106-116 21. tehu D;k gS@tk;nkn dk cSukek D;ksa t:jh gSA 117-124 22. eksVj okgu iathdj.k 125 23. fl[kkbZ MªkbZfoax ykblSal 126 24. LFkkbZ MªkbZfoax ykblSal 127-152 25. f'kf{kr csjkstxkjksa ds fy, csjkstxkjh HkÙkk 153-159 26. ofj"B ukxfjd igpku i= 160-161 27. dkuwuh lgk;rk dsUnz 162-175 1

o`}koLFkk lEeku HkÙkk ;kstuk

ç’u1 o`}koLFkk isa’ku ;kstuk dk mn~ns’; D;k gS\ mrj bl ;kstuk dk mnn~s’; lekt esa t:jrean yksxksa dks tSls fd d`f"k etnwj] xzkeh.k nLrdkj] vuqlwfpr tkfr o fiNM+h tkfr o NkVss fdlku bR;kfn dks mudh o`} voLFkk esa ykHk lqfuf’pr djuk gSA dksbZ o`} O;fDr] tks vius Loa; ds L=ksrkas ls thou;kiu djus esa vleFkZ gS vkSj ftls ljdkj ls fofÙk; lgk;rk dh t:jr gS] mls bl ;kstuk }kjk lkekftd lqj{kk iznku dh xbZ gSA ç’u2 o`}koLFkk isa’ku ;kstuk ds fy, dkSu ik= gS\ mrj 1) o`}koLFkk isa’ku ds fy, og O;fDr ik= gSa%& i) tgk¡ ifr ,oa iRuh dh lHkh L=ksrksa ls okf"kZd vk; 2.00 yk[k ls vf/kd ugha gSA ii) ftldh vk;q 60 o"kZ ;k blls vf/kd gSA iii) tks gfj;k.kk jkT; dk vf/koklh ,oa LFkkbZ fuoklh gSA 2) ;fn ifr&iRuh nksuksa gh isa’ku ds fy, ;ksX; gSa rks nksuksa vyx&vyx isa’ku ysus ds gdnkj gksaxsA 3) ;fn dksbZ O;fDr fdlh Hkh ljdkj ls iSa’ku izkIr dj jgk gS rks og iSa’ku dk ik= ugha gSA ç’u3 o`}koLFkk isa’ku ;kstuk ds fy, dkSu ik= ugha gS\ mrj fuEufyf[kr O;fDr o`}koLFkk is’kua ds ik= ugha gSa%& 1) tks Loa; ;k mlds cPps fcØh&dj ds nk;js esa vkrs gSaA 2) ;fn vkosnd ljdkj ;k LFkkuh; fudk; ls isa’ku ys jgk gks ;k dksbZ laxBu ¼ftls ljdkj] LFkkuh; fudk;] cksMZ ;k fuxe }kjk foÙkh; lgk;rk iznku dh tkrh gS½ rc og ;kstuk ds vUrxZr HkÙkk ysus dk ik= ugha gSA ç’u4 isa’ku ds ik= O;fDr dks D;k jkf’k nh tkrh gS\ mrj bl jkT; ;kstuk ds vUrxZr gfj;k.kk jkT; ds LFkkbZ fuoklh ftlusa 60 o"kZ ;k T;knk vk;q iwjh dj j[kh gS mudks 1200/- :i;s 1.1.2015 ds ckn ds ykHkik=kas dks HkÙkk fn;k tkrk gSA 2

ç’u5 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh ds dk;kZy; esaA (ii) 'kgj Lrj ij & uxj ikfydk@uxj ifj"kn vkSj uxj fuxe ds dk;kZy;A ç’u6 vkosnu dh tkap fdl vf/kdkjh }kjk th tkrh gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh }kjk dh tkrh gSA (ii) 'kgjh Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe }kjk dh tkrh gSA ç’u7 isa’ku ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M iapk;r ,oa fodkl vf/kdkjh dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku@HkÙkk Lohd`r fd;k tkrk gAS (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku@HkÙkk Lohd`r fd;k tkrk gSA ç’u8 isa’ku dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & xke izapk;rksa }kjk fd;k tkrk gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dk;kZy; ds deZpkjh;ka s }kjk fd;k tkrk gSA

   3

dEi;wVj }kjk tkjh ykHkik= igpku dksM ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk o`)koLFkk lEeku HkÙkk ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. izkFkhZ dk uke Jh@Jhefr------

2. firk@ifr dk uke Jh------

3. tUe frfFk ¼Ldwy izek.k@tUe frfFk izek.k MªkbZfoax ykblSUl@ikliksZV@oksVj igpku tUe frfFk------vk;q------dkMZ dh Lo;a }kjk lR;kfir izek.k&i= ¼izfr layXu djsaA½ izek.k tks layXu fd;k x;k gS------uksV%& ;fn vkosnd }kjk tUe frfFk izek.k&i= layXu ugha fd;k x;k gS] rks vkosnd dks eSfMdy ckMZ esa vk;q tkap gsrq is’k gksuk gksxk ¼Hkkx&d½

4. iw.kZ LFkkbZ irk ------

5. xjhch js[kk lwph la[;k ------

6. gfj;k.kk jkT; vf/koklh\ gk¡ ugha

7. D;k izkFkhZ vuqlwfpr tkfr ls lacaf/kr gS\ gk¡ ugha

8. fiNM+k oxZ\ gk¡ ugha

9. D;k vkosnd ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ cksMZ@fuxe ;k fdlh m|e ls lsokfuo`r gqvk gS\ gk¡ ugha ;fn gk¡] rks iw.kZ fooj.k nhft,A

10. D;k vkosnd ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ cksMZ@fuxe@laxBu@dEiuh] ftlesa fdlh Hkh ljdkj@ LFkkuh; fudk; }kjk foÙkh; fuos’k@lgk;rk iznku dh gk¡ ugha Tkkrh gS] ls vk;@ih0,Q0 jkf’k Hkh vk; esa 'kkfey gS½ isa'ku@ikfjokfjd isa’ku izkIr dj jgk gS\

11. ifr ,oa iRuh nksuksa dh lHkh lk/kuksa ls okf"kZd vkenuh ------

vkosnd ds gLrk{kj@vaxwBs dk fu’kku 4

-2- 'kiFk eSa Jh@Jhefr------iq=@iq=h@iRuh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn esjs }kjk xyr rF; crkdj HkÙkk izkIr fd;k x;k rks ljdkj dks esjh lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr fd, x, HkÙks dh olwyh djus dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------

¼d½ vkosnd }kjk tUe izek.k i= layXu u djus ij nks lnLlh; eSfMdy cksMZ dh flQkfj’k

izkFkhZ dk gLrk{kj@vaxwBs dk fu’kku eSfMdy cksMZ ds le{k izkFkhZ dh vuqekfur vk;q % ------o"kZ ls ------o"kZ rd 1. gLrk{kj 2. gLrk{kj fpfdRlk vf/kdkjh dk fpfdRlk vf/kdkjh dk iwjk uke ------iwjk uke ------in lack ¼LVSEi lfgr½------in lack ¼LVSEi lfgr½------lh0,p0lh0@vLirky dk lh0,p0lh0@vLirky dk uke o LFkku------uke o LFkku------frfFk------gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh@ lfpo] uxj fuxe@ukxfjd lsok dsUnz (CSC) uke------in------uksV%& iw.kZ vkosnu i= izkIr gksus dh fLFkfr esa izkFkhZ dks uhps jlhn nsosa ,oa vkosnu&i= ftyk lekt dY;k.k vf/kdkjh ds dk;kZy; dks vxzsf"kr dj sa vU;Fkk vkosnu&i= dkj.k lfgr izkFkhZ dks okfil ykSVk;A sa

¼[k½ ftyk lekt dY;k.k vf/kdkjh fVIi.kh------Lohd`r vLohd`r

frfFk------gLrk{kj------5 vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jhefr------firk@iRuh------fuoklh------ls fnukad------dks o`)koLFkk lEeku HkÙkk gsrw QkeZ izkIr gqvkA

gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh lfpo] uxj fuxe@ukxfjd lso dsUn z (CSC)

uke------in------6

fo/kokvksa vkSj cslgkjk vkSjrksa ds fy, gfj;k.kk ljdkj isa’ku ;kstuk ¼fo/kok iSa’ku½

ç’u1 fo/kokvkas vkSj cslgkjk vkSjrksa dks isa’ku ;kstuk dk mnn~s’; D;k gS\ mrj bl ;kstuk dk mn~ns’; mu fo/kokvksa ;k cslgkjk efgykvksa dks lkekftd lqj{kk iznku djuk gS tks vius Loa; ds L=ksrksa dks cuk;s j[kus esa vleFkZ gks vkSj ftUgsa ljdkj ls fofÙk; lgk;rk dh t:jr gkAs ç’u2 fo/kokvkas vkSj cslgkjk vkSjrksa dks isa’ku ;kstuk ds fy, dkSu ik= gS\ mrj bl Ldhe ds vUrxZr dksbZ Hkh efgyk ftldh vk;q 18 o"kZ ;k blls vf/kd gks] isa’ku ds fy, ik= gS ;fn og gfj;k.kk dh fuoklh gS vkSj izkFkZuk i= ds le; ls ,d o"kZ ls igys gfj;k.kk jkT; esa jgrh gks vkSj mldh lkykuk vk; vius L=ksrksa ls 2,00,000/- :i;s ls de gks rFkk og fuEufyf[kr rhu 'krksZa esa ls fdlh ,d dks iwjk djrh gks ;fn%& i) og fo/kok gks( ;k ii) og ifr] ekrk&firk vkSj cVss ds fcuk cslgkjk gks( ;k iii) og cslgkjk gks&  vius ifr }kjk ifjR;kx ;k ifr dh 'kkjhfjd vFkok ekufld v{kerk ds dkj.k ¼'kknh’kqnk efgyk ds ekeys esa½A  ekrk&firk }kjk ifjR;kx ;k ekrk&firk dh 'kkjhfjd vFkok ekufld v{kerk ds dkj.k ¼vU; efgykvksa ds ekeys esa½A ç’u3 isa’ku ;kstuk ds fy, dkSu ik= ugha gS\ mrj ,slh efgyk] ftls ljdkj] LFkkuh;] lkoZtfud miØe ;k dksbZ laLFkk ¼ftldks ljdkj ls fofr; lgk;rk izkIr gS½ ds }kjk ukSdjh nh xbZ gks vkSj tks isa’ku ;k ifjokfjd isa’ku ys jgh gks] og bl ;kstuk ds vUrxZr isa’ku dh ik= ugha gksxhA 7

ç’u4 isa’ku dh ik= efgykvksa dks D;k jkf’k nh tkrh gS\ mrj bl ;kstuk ds vUrxZr fo/kok o cslgkjk efgykvksa dks 1200/- :i;s 1.1.2015 ds ckn ds ykHkik=kas dks izfr ekg isa’ku nh tkrh gSA ç’u5 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh ds dk;kZy; esaA (ii) 'kgj Lrj ij & uxj ikfydk@uxj ifj"kn vkSj uxj fuxe ds dk;kZy; esaA ç’u6 vkosnu dh tkap fdl vf/kdkjh }kjk dh tkrh gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh }kjk dh tkrh gSA (ii) 'kgjh Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe }kjk dh tkrh gSA ç’u7 isa’ku ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa ipk;ra vf/kdkjh dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku Lohd`r dh tkrh gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku Lohd`r dh tkrh gSA ç’u8 isa’ku dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & xke izapk;rks }kjk fd;k tkrk gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dk;kZy; ds deZpkjh;ka s }kjk fd;k tkrk gSA

   8

dEi;wVj }kjk tkjh ykHkik= igpku dksM ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk fo/kok@fujkfJr isa’ku ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. izkFkhZ dk uke Jh@Jhefr------

2. firk@ifr dk uke Jh------

3. tUe frfFk ¼tUe izek.k&i=½ ------vk;q------

4. iw.kZ LFkkbZ irk ------

5. xjhch js[kk lwfp la[;k ------

6. D;k izkFkhZ;k gfj;k.kk jkT; vf/koklh gS\ gk¡ ugha

7. D;k izkFkhZ;k vuqlwfpr tkfr ls lacaf/kr gS\ gk¡ ugha

8. D;k izkFkhZ;k fiNM+k oxZ ls lacaf/kr gS\ gk¡ ugha

9. ;fn fo/kok gS] rks ifr dh e`R;q frfFk ------¼e`R;q izek.k&i= layXu djsa½

10. ;fn fo/kok gS] rks cslgkjk gksus dk dkj.k------¼;fn txg de gS] rks vyx iUus ij foLr`r fooj.k nsa½

11. D;k vkosnd ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ fudk;@cksMZ@fuxe@ ;k fdlh m|e esa ukSdjh dj dj jgh gSa ;k lsokfuo`r gqbZ gS\ gka ugha ;fn gk¡] rks iw.kZ fooj.k nsaA

12. D;k vkosnd fdlh ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ cksMZ@fuxe@laxBu@dEiuh] ftlesa fdlh Hkh ljdkj@ LFkkuh; fudk; }kjk foÙkh; fuos’k@lgk;rk iznku dh Tkkrh gS] ls vk;@isa’ku@ikfjokfjd isa’ku izkIr dj jgh gS\ gka ugha

13. ;fn vkosnd fo/kok gS] rks Lo;a dh lHkh lk/kuksa ls Okkf"kZd vkenuhA ¼blesa osru] isa’ku] ikfjokfjd isa’ku] lsokfuo`fr ij feyus okyh isa’ku] ih0,Q0 ij feyus okyk C;kt vkfn Hkh 'kkfey gS½ ------9

14. ;fn vkosnd cslgkjk efgyk gS] rks ifjokj ds lHkh lnL;ksa dh lHkh lk/kuksa ls okf"kZd vkenuhA ------

vkosnd ds gLrk{kj@vaxwBs dk fu’kku

'kiFk eSa Jh@Jhefr------iq=@iq=h@iRuh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn esjk iquZ fookg gqvk ¼fo/kok ds fy;s½ rks] eSa ftyk dY;k.k vf/kdkjh dks rqjUr lwfpr d:axhA mijksDr fooj.k esa ls dksbZ Hkh rF; vxj xyr ik;k tkrk gS] rks ljdkj dks esjh lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr fd, x, HkÙks dh olwyh djus dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------

¼d½ fo/kok@clgkjks efgyk isa’ku

frfFk------gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh@ lfpo] uxj fuxe@ukxfjd lsok dsUnz (CSC) uke------in------uksV%& iw.kZ vkosnu i= izkIr gksus dh fLFkfr esa izkFkhZ dks uhps jlhn nsosa ,oa vkosnu&i= ftyk lekt dY;k.k vf/kdkjh ds dk;kZy; dks vxzsf"kr dj sa vU;Fkk vkosnu&i= dkj.k lfgr izkFkhZ dks okfil ykSVk;A sa

ftyk lekt dY;k.k vf/kdkjh

Lohd`r vLohd`r

frfFk------gLrk{kj------10 vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jhefr@dqekjh------firk@iRuh------fuoklh------ls fnukad------dks fo/kok@cslgkjk isa’ku gsrq QkeZ izkIr gqvkA

gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh lfpo] uxj fuxe@ukxfjd lso dsUn z (CSC)

uke------in------11

gfj;k.kk fodykax O;fDr isa’ku ;kstuk ¼fodykax iSa’ku½

ç’u1 fodykxa O;fDr;ksa dks isa’ku ;kstuk dk mn~ns’; D;k gS\ mrj bl ;kstuk dk mnn~s’; mu fodykax O;fDr;ksa dks] tks vius Loa; ds L=ksrkas dks cuk;s j[kus esa vleZFk gks vkSj ftUgsa ljdkj ls fofÙk; lgk;rk dh t:jr gks] mUgsa lkekftd lqj{kk iznku djuk gSA ç’u2 isa’ku ;kstuk ds fy, dkSu ik= gS\ mrj bl Ldhe ds vUrxZr dksbZ Hkh fodykax O;fDr tks 18 o"kZ ;k blls vf/kd gks] fodykax is’ku ds vuaqnku ds fy, ik= gSA ;fn og gfj;k.kk dk fuoklh gS vkSj izkFkZuk i= ds le; ls rhu o"kZ ls gfj;k.kk jkT; esa jgrk gS rFkk mls vius utnhdh fj’rsnkjksa tSls fd ekrk&firk] iq=] ikS= ls enn izkIr ugha gks jgh rFkk mldh lkykuk vk;] lHkh L=ksrksa dks feykdj] Je foHkkx }kjk o"kZ nj o"kZ vf/klwfpr] vdq’ky] Jfed dh U;wure etnwjh ls T;knk ugha gSA rFkk & ;fn og xqaxk@cgjk ;k 100% us=ghu gS ;k & 70% ;k vf/kd viax gS ;k & mldh ekufld v{kerk (I.Q.) 50 ls vf/kd ugha gSA ç’u3 isa’ku ds ik= fodykax O;fDr dks D;k jkf’k nh tkrh gS\ mrj bl ;kstuk ds vUrxZr fodykax O;fDr dks 1200/- :i;s 1.1.2015 ds ckn ds ykHkik=ksa dks izfr ekg ds fglkc ls isa’ku nh tkrh gAS ç’u4 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh dk;kZy; esa vkosnu fn;k tk;sxkA (ii) 'kgj Lrj ij & uxj ikfydk@uxj ifj"kn vkSj uxj fuxe ds dk;kZy; esa vkosnu fn;k tk;sxkA 12

ç’u5 vkosnu dh tkap fdl vf/kdkjh }kjk dh tkrh gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh }kjk dh tkrh gSA (ii) 'kgjh Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe }kjk dh tkrh gSA ç’u6 isa’ku ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M iapk;r ,oa fodkl vf/kdkjh dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku Lohd`r dh tkrh gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkjS uxj fuxe }kjk laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku Lohd`r dh tkrh gSA ç’u7 isa’ku dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & xzke iapk;r }kjk fd;k tkrk gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dk;kZy; ds deZpkjh;ka s }kjk fd;k tkrk gSA

   13

dEi;wVj }kjk tkjh ykHkik= igpku dksM ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk fodykax isa’ku ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. izkFkhZ dk uke Jh@Jhefr------

2. firk@ifr dk uke Jh------

3. tUe frfFk ¼tUe izek.k&i=½ ------vk;q------

4. iw.kZ LFkkbZ irk ------

5. xjhch js[kk lwfp la[;k ¼;fn ch0ih0,y0------ifjokj gS] rks

6. fodykaxrk dk izfr’kr ------¼fodykaxrk izek.k i= layXu djsa] tks fd 3 o"kZ ls T;knk iqjkuk u gks½

7. D;k izkFkhZ;k gfj;k.kk jkT; vf/koklh gS\ gk¡ ugha

8. D;k izkFkhZ;k vuqlwfpr tkfr ls lacaf/kr gS\ gk¡ ugha

9. D;k izkFkhZ;k fiNM+s oxZ ls lacaf/kr gS\ gk¡ ugha

10. D;k vkosnd fdlh ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ cksMZ@fuxe ;k fdlh m|e@dEiuh] ftlesa fdlh Hkh ljdkj@LFkkuh; fudk; }kjk foÙkh; fuos’k@lgk;rk iznku dh Tkkrh gS] ls vk;@isa’ku@ikfjokfjd isa’ku gka ugha izkIr dj jgh gS\ ;fn gk¡] rks fooj.k nsaA ------

12. vkosnd dh lHkh lk/kuksa ls okf"kZd vk; ------¼blesa osru] isa’ku] ikfjokfjd isa’ku] ih0,Q0 ij feyus okyk C;kt vkfn Hkh lfEefyr gS½ ------

vkosnd ds gLrk{kj@vaxwBs dk fu’kku 14

-2-

'kiFk eSa Jh@Jhefr@d0q ------iq=@iq=h@iRuh@Jh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn mijksDr fooj.k esa ls dksbZ Hkh rF; vxj xyr ik;k tkrk gS] tks ljdkj dks esjh lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr olwy djus dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------

¼d½ fodykax isa’ku

ftyk lekt dY;k.k vf/kdkjh

Lohd`r vLohd`r

frfFk------gLrk{kj------

 ;fn vkosnd viaxrk ds dkj.k gkFk ds vaxwBs@maxyh dk fu’kku ugha yxk ldrk] rks ml voLFkk esa ikao ds vaxwBs dk fu’kku yxk;k tk;sA  ;fn nksuksa gkFk&ikoa u gksus ds dkj.k] vkosnd gLrk{kj djus ;k vaxwBs@mxyh dk fu’kku yxkus esa vleFkZ gks] rks mldk laj{kd mldh vkSj ls gLrk{kj ;k vaxwBs dk fu’kku yxk ldrk gSA 15 vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jhefr@dqekjh------firk@iRuh------fuoklh------ls fnukad------dks fodykax isa’ku gsrq QkeZ izkIr gqvkA

gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh lfpo] uxj fuxe@ukxfjd lso dsUnz (CSC)

uke------in------16

gfj;k.kk ljdkj dh ykMyh lkekftd lqj{kk HkÙkk ;kstuk iz’u1 ykMyh lkekftd lqj{kk ;kstuk ls D;k vfHkizk; gS\ mrj ;g ;kstuk o`} lEeku HkÙkk ;kstuk dh rjg mu ifjokjksa ds fy, g]S ftuesa flQZ yM+dh@yM+fd;ka gSA ç’u2 HkÙkk ;kstuk ds fy, dkSu ik= gS\ mrj bl ;kstuk ds vUrxZr HkÙkk ikus ds fy,] og ,dy ekrk ;k firk vFkok ekrk&firk] ik= gS tk%&s (1) gfj;k.kk dk fuoklh ;k gfj;k.kk ljdkj esa dk;Zjr gks rFkk( (2) ftuds ikl dsoy yM+dh ;k yM+fd;ka gksA dksbZ fu%Lrku O;fDr vxj dksbZ yM+dh xksn ysrk gS rks og Hkh bl ;kstuk dk ik= gksxk rFkk( (3) ftldh vk;q 45 o"kZ ls de vkSj 60 o"kZ ls T;knk ugha gks rFkk( (4) ftlds ifjokj dh lkykuk vk; lHkh L=ksrksa dks feykdj 2,00,000 :i;s ls T;knk ugha gAS ç’u3 D;k ;g HkÙkk ekrk ;k firk dh e`R;q ij thfor ekrk ;k firk dks feyrk gS\ mrj vxj ekrk&firk esa ls fdlh ,d dh Hkh e`R;q gks tkrh gS rks vfHkHkkod dks fu/kkfjr Z 45 lky dh vk;q rd HkÙkk feyrk jgxkAs ç’u4 lEeku HkÙkk ds ik= O;fDr dks D;k jkf’k nh tkrh gS\ mrj bl ;kstuk ds vUrxZr ik= O;fDr dks 1200/- izfr ekg ds fglkc ls lEeku HkÙkk jkf’k nh tkrh gSA ç’u5 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r dk;kZy; esa vkosnu fn;k tk;sxkA (ii) 'kgj Lrj ij & uxj ikfydk@uxj ifj"kn vkSj uxj fuxe ds dk;kZy; esa vkosnu fn;k tk;sxkA 17

ç’u6 vkosnu dh tkap fdl }kjk dh tkrh gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa iapk;r vf/kdkjh }kjk dh tkrh gSA (ii) 'kgjh Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe }kjk dh tkrh gSA ç’u7 HkÙkk ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & [k.M fodkl ,oa ipk;ra vf/kdkjh dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku@HkÙkk Lohd`r fd;k tkrk gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk isa’ku@HkÙkk Lohd`r fd;k tkrk gSA ç’u8 HkÙkk dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ij & xke izapk;rksa }kjk fd;k tkrk gSA (ii) 'kgj Lrj ij & lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dk;kZy; }kjk fd;k tkrk gSA

   18

dEi;wVj }kjk tkjh ykHkik= igpku dkMs ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk ykMyh lkekftd lqj{kk HkÙkk ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. eka dk uke ------¼vxj eka thfor gS] rks HkÙks dh jkf’k eka ds [kkrs esa tk;sxh½

2. izkFkhZ dk uke ------

3. vkosnd ds firk@ifr dk uke ------

4. vkosnd dh tUe frfFk@vk;q ------vk;q------

5. vkosnd ds cPpksa dk iw.kZ fooj.k% ------

uke tUe frfFk iq:"k@efgyk ¼izek.k i= layXu djsa½ 1. 2. 3. 4. 5.

6. iw.kZ LFkkbZ irk ------

7. xjhch js[kk lwfp la[;k ------

8. D;k vkosnd gfj;k.kk jkT; dk vf/k'kklh gS\ gk¡ ugha

9. D;k vkosnd vuqlwfpr tkfr ls lacaf/kr gS\ gk¡ ugha

10. D;k vkosnd fiNM+s oxZ ls lacaf/kr gS\ gk¡ ugha

11. ifjokj dh lHkh lk/kuksa ls okf"kZd vkenuhA ------¼blesa osaru] isa’ku ikfjokfjd isa’ku] ih0,Q0 ij feyus okyk C;kt vkfn Hkh 'kkfey gSA½

vkosnd ds gLrk{kj@vaxwBs dk fu’kku 19

-2-

'kiFk eSa Jhefr@dq0------iq=h@iRuh@Jh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs loksZÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA esjk dksbZ iq= ugha gS ;k dksbZ yM+dk xksn ugha fy;k gqvk gS] ;fn ejss xyr rF; crkdj HkÙkk izkIr fd;k x;k gks rks] ljdkj dks esjh lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr dh xbZ jkf’k dh olwyh dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------ykMyh lkekftd lqj{kk HkÙkk

ftyk lekt dY;k.k vf/kdkjh

Lohd`r vLohd`r

frfFk------gLrk{kj------20 vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jhefr@dqekjh------iq=h@iRuh------fuoklh------ls fnukad------dks ykMyh lkekftd lqj{kk HkÙkk gsrq QkeZ izkIr gqvkA

gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh lfpo] uxj fuxe@ukxfjd lso dsUn z (CSC)

uke------in------21

ckSuk HkÙkk ;kstuk iz’u1 ckSuk lgk;rk ;kstuk ls D;k vfHkizk; gS\ mrj ckSuk oxZ lekt esa lkekftd o vkfFkdZ :i ls ,d eg:e oxZ gSA blfy, gfj;k.kk izkUr esa ckSuksa dh detksj vkfFkdZ n’kk dks eís utj j[krs gq, mUgsa fofÙk; lgk;rk nsus ds fy, tks ;kstuk cukbZ xbZ gS mls ckSuk HkÙkk ;kstuk dk uke fn;k x;k gAS ç’u2 ckSuk dh ifjHkk"kk D;k gS\ mrj 1) og iq:"k O;fDr ftldk dn 3 QqV 8 bap ;k blls de gksA 2) og efgyk ftldk dn 3 QqV 3 bap ;k blls de gksA ç’u3 ckSuk lgk;rk ;kstuk ds fy, dkSu ik= gS\ mrj bl ;kstuk ds vUrxZr fuEufyf[kr ik= gSa%& 1) tks gfj;k.kk dk fuoklh gS vkSj fiNys ,d o"kZ ls izns’k esa jg jgk gSA 2) ftldh vk;q 18 o"kZ ls de u gSA 3) ftlds ikl flfoy ltZu }kjk tkjh fd;k x;k izek.k i= gSA ç’u4 ckSuk lgk;rk ;kstuk ds vUrxZr D;k jkf’k nh tkrh gS\ mrj ckSuk lgk;rk ;kstuk ds vUrxZr 1200/- :i;s 1.1.2015 ds ckn ds ykHkik=kas dks ckSuk HkÙkk fn;k tkrk gS ¼;k tks gfj;k.kk ljdkj }kjk le;≤ ij vf/klwfpr fd;k tk,xk½A ç’u5 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj ckSuk lgk;rk ;kstuk ds vUrxZr vkonus i= ftyk lekt dY;k.k dk;kZy; esa fu%’kqYd fn;k tkrk gSA vkonus i= ds lkFk fpfdRlk izek.k i= yxkuk vfuok;Z gSA ç’u6 vkosnu i= dh tkap ds fdl }kjk dh tkrh gS o fdl vf/kdkjh }kjk Lohd`fr iznku dh tkrh gS\ mrj vkonsu i= dh tk¡p ftyk lekt dY;k.k dk;kZy; ds tk¡pdrkZ }kjk dh tkrh gSA ftlds vk/kkj ij ftyk lekt dY;k.k vf/kdkjh vkosnu dks Lohd`fr iznku djrk gSA ç’u7 lgk;rk dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj lgk;rk dk Hkqxrku iapk;rh jkt laLFkk }kjk fd;k tkrk gS ;k fdlh vkSj ek/;e ls le;≤ ij ljdkj }kjk QSalyk fd;k tkrk gAS    22

dEi;wVj }kjk tkjh ykHkik= igpku dkMs ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk cksuk HkÙkk ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. izkFkhZ dk uke ------

2. firk@ifr dk uke ------

3. tUe frfFk ¼tUe izek.k i= layXu djsa½ ------vk;q------

4. vkosnd dk mapkbZ@dn ------¼eSfMdy izek.k&i= layXu djsa½ ------

5. iw.kZ irk ------

5.¼d½ fdl frfFk ls ------

6. xjhch js[kk lwfp la[;k ------

7. D;k vkosnd gfj;k.kk jkT; dk vf/koklh gS\ gk¡ ugha

vkosnd ds gLrk{kj@vaxwBs dk fu’kku

'kiFk eSa] Jh@Jhefr@dq0------iq=@iq=h@iRuh@Jh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn esjs xyr rF; crkdj HkÙkk izkIr fd;k x;k gks rks] ljdkj dks ejhs lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr dh xbZ jkf’k dh olwyh dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------23

ftyk lekt dY;k.k vf/kdkjh

Lohd`r vLohd`r

frfFk------gLrk{kj------

vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jhefr@dqekjh ------iq=@firk@iRuh ------fuoklh ------ls fnukad ------dks fodykxa isa’ku gsrq QkeZ izkIr gqvkA

gLrk{kj------[k.M fodkl ,oa iapk;r vf/kdkjh lfpo] uxj fuxe@ukxfjd lso dUs nz (CSC)

uke------in------24

fdUuj ¼fgtM+k½ HkÙkk ;kstuk iz’u1 fdUuj ¼fgtM+k½ lgk;rk ;kstuk ls D;k vfHkizk; gS\ mrj fdUuj ¼fgtM+k½ lgk;rk ;kstuk ls vfHkizk; gS & og ;kstuk ftl }kjk fdUujkas ¼fgtM+ksa½ dh n’kk dks eís utj j[krs gq, fofÙk; lgk;rk iznku dh tkrh gSA ç’u2 fdUuj ¼fgtM+k½ lgk;rk ;kstuk ds fy, dkSu ik= gS\ mrj bl ;kstuk ds vUrxZr fuEufyf[kr ik= gkxk%&s 1) tks gfj;k.kk izkUr dk LFkkbZ fuoklh gks ;k tks izkFkZuk i= ds vkosnu ds le; ls ikap o"kZ ls izns’k esa jgrk gksA 2) ftldh vk;q 18 o"kZ ls de u gksA 3) ftl ds ikl flfoy ltZu dk izek.k i= gksA 4) tks dHkh xSj dkuuh w xfrfof/k;k sa esa 'kkfey uk jgk gksA ç’u3 fdUuj ¼fgtM+k½ lgk;rk ;kstuk ds vUrxZr D;k jkf’k nh tkrh gS\ mrj fdUuj ¼fgtM+k½ lgk;rk ;kstuk ds vUrxZr 500 :i;s çfrekl izfr ykHkik= nh tkrh gSA ç’u4 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj fdUuj ¼fgtM+k½ lgk;rk ;kstuk ds vUrxZr vkonsu i= ftyk lekt dY;k.k dk;kZy; eas fn;k tkrk gSA vkonus i= ds lkFk fpfdRlk izek.k i= yxkuk t:jh gSA ç’u5 vkosnu i= dh tkap fdl vf/kdkjh }kjk dh tkrh gS\ mrj vkonsu i= dh tk¡p ftyk lekt dY;k.k dk;kZy; ds tk¡pdrkZ }kjk dh tkrh gSA ç’u6 lgk;rk ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj lgk;rk dk vkonsu i= tk¡pdrkZ dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk Lohd`r fd;k tkrk gSA ç’u7 lgk;rk dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj lgk;rk dk Hkxrkuq ia pk;rh jkt laLFkk }kjk fd;k tkrk gSA    25

dEi;wVj }kjk tkjh ykHkik= igpku dkMs ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk fdUuj HkÙkk ds fy, vkosnu&i= QksVks

ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. izkFkhZ dk uke ------

2. firk@ifr dk uke ------

3. tUe frfFk ¼tUe izek.k i= layXu djsa½ ------vk;q------

4. vkosnd dk fpfdRlk izek.k&i= ------¼dkih layXu djsa½ ------

5. irk ------

5.¼d½ mijksDr irs ij fdl frfFk ls ------jgrk gSA ------

6. xjhch js[kk lwfp la[;k ------

7. D;k vkosnd gfj;k.kk jkT; dk vf/koklh gS\ gk¡ ugha

8. D;k vkosnd dHkh fdlh vijkf/kd xfrfof/k;ksa gk¡ ugha esa lafyIr jgk gS@;k gS\ ;fn gka] rks fooj.k nsaA

vkosnd ds gLrk{kj@vaxwBs dk fu’kku

'kiFk eSa] Jhefr@dq0------iq=h@iRuh@Jh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn esjs xyr rF; crkdj HkÙkk izkIr fd;k x;k gks rks] ljdkj dks ejhs lHkh izdkj dh isa’ku@HkÙkk cUn djus o 12 izfr’kr C;kt lfgr izkIr fd;s x;s HkÙks dh jkf’k dh olwyh dk gd gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------26

ftyk lekt dY;k.k vf/kdkjh

Lohd`r vLohd`r

frfFk------gLrk{kj------

vkosnu i= izkfIr jlhn Øekad------fnukad------uke ------firk ------fuoklh ------ls fnukad ------dks fdUuj HkÙkk gsrq QkeZ izkIr gqvkA

gLrk{kj------ftyk lekt dY;k.k vf/kdkjh 27

fujkfJr cPpksa dks foÙkh; lgk;rk ;kstuk iz’u1 cslgkjk cPpk lgk;rk ;kstuk ls D;k vfHkizk; gS\ mrj ;g og ;kstuk gS ftlds vUrxZr vukFk cPpkas ds thou Lrj dks lq/kkjus ds fy, HkÙkk fn;k tkrk gSA ç’u2 cslgkjk cPpk lgk;rk ;kstuk ds fy, dkSu ik= gS\ mrj bl ;kstuk ds vUrxZr fuEufyf[kr cPps ik= gksxsa%& 1) gfj;k.kk ds fuoklh gk s rFkk gfj;k.kk ds vf/koklhA 2) ftudh vk;q 21 o"kZ ls de gksA ;k 3) ftuds ekrk&firk dh e`R;q gks pqdh gkAs ;k 4) ftuds firk nks o"kZ ls T;knk le; ls ykirk gSA ;k 5) ftuds ekrk ;k firk dks ltk gks xbZ gks tks ,d o"kZ ls de u gkAs ;k 6) ftuds ekrk@firk 'kkjhfjd vFkok ekufld :i ls v’kDr gksA ;k 7) ftuds ekrk&firk ;k vfHkHkkod dh lkykuk vk; 2,00,000/- :i;s ls de gksA ç’u3 cslgkjk cPpk lgk;rk ;kstuk ds ik= cPps dks D;k jkf’k nh tkrh gS\ mrj cslgkjk cPpk lgk;rk ;kstuk ds ik= cPps dks 500/- :i;s izfr ekg lgk;rk jkf’k nh tkrh gSA ;g lgk;rk ifjokj esa nks cPpksa rd gh lhfer gSA ç’u4 vkosnu fdl dk;Zy; esa fn;k tkrk gS\ mrj xkeh.kz Lrj ij ik= cPpk viuk i= [k.M fodkl ,oa iapk;r vf/kdkjh ds dk;kZy; esa ns ldrk gAS 'kgj Lrj ij ik= cPpk viuk izkFkZuk i= uxj ikfydk@uxj ifj"kn vkSj uxj fuxe ds dk;kZy; eas ns ldrk gSA 28

ç’u5 vkosnu dh tkap fdl vf/kdkjh }kjk dh tkrh gS\ mrj xkeh.kz Lrj ds cPpksa ds vkosnu dh tk¡p [k.M fodkl ,oa iapk;r vf/kdkjh }kjk dh tkrh gSA 'kgjh Lrj ds cPpksa ds vkosnu dh tk¡p lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe }kjk dh tkrh gSA ç’u6 lgk;rk ds vkonsu dks fdl vf/kdkjh }kjk Lohdkj fd;k tkrk gS\ mrj (i) xzkeh.k Lrj ds ik= cPpksa dk vkonsu [k.M fodkl ,oa iapk;r vf/kdkjh dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk foÙkh; lgk;rk Lohd`r fd;k tkrk gSA (ii) 'kgj Lrj ds ik= cPpksa dh foÙkh; lgk;rk lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dh laLrqfr ¼Recommendation½ ij ftyk lekt dY;k.k vf/kdkjh }kjk Lohd`r fd;k tkrk gSA ç’u7 lgk;rk dk Hkqxrku fdl }kjk fd;k tkrk gS\ mrj (i) lgk;rk dk Hkqxrku xzkeh.k Lrj ij xzke iapk;rks }kjk fd;k tkrk gSA (ii) lgk;rk dk Hkqxrku 'kgj Lrj ij lfpo@dk;Zdkjh vf/kdkjh] uxj ikfydk@uxj ifj"kn vkSj uxj fuxe dk;kZy; }kjk fd;k tkrk gSA

   29

dEi;wVj }kjk tkjh ykHkik= igpku dkMs ua0------lkekftd U;k; ,oa vf/kdkfjrk foHkkx] gfj;k.kk fujkfJr cPpksa dks foÙkh; lgk;rk gsrq vkosnu&i= QksVks cPps dh cPps dh QksVks QksVks ftyk------[k.M@’kgj------xzke@okMZ------vkosnu frfFk------

1. cPpksa dk uke o tUe frfFk 1.------tUe frfFk------¼tUe izek.k&i= layXu djsa½ 2.------tUe frfFk------

2. laj{kd dk uke ------

3. laj{kd dk cPpksa ls fj’rk ------4. laj{kd dk iw.kZ LFkkbZ irk ------5. cslgkjk dk dkj.k ------

6. cPpksa ds cslgkjk gksus dk dkj.k ------¼;fn txg de gS] rks vyx iUus ij foLr`r fooj.k nsa½

7. D;k laj{kd xjhch js[kk lwfp esa lfEefyr gS] ;fn gka rks xjhch js[kk la[;k ------

8. D;k vkosnd gfj;k.kk jkT; dk vf/koklh gS\ gk¡ ugha

9. D;k vkosnd vuqlwfpr tkfr ls lacaf/kr gS\ gk¡ ugha

10. D;k vkosnd fiNM+s oxZ ls lacaf/kr gS\ gk¡ ugha

11. laj{kd dk igpku&i= ¼dkWih layXu djsa½ ------

12. D;k vkosnd ljdkjh@v/kZ ljdkjh@LFkkuh; ------fudk;@cksMZ@fuxe@ ;k fdlh m|e esa ukSdjh ------dj jgk gSa@lsokfuo`r gqvk gS\ ------;fn gka] rks iw.kZ fooj.k nhft,A ------

13. D;k vkosnd ljdkjh@v/kZ ljdkjh@LFkkuh; fudk;@ gk¡ ugha cksM@fuxe@laxBu@dEiuh]Z ftlesa fdlh Hkh ljdkj@ LFkkuh; fudk; }kjk foÙkh; fuos’k@lgk;rk iznku 30

dh tkrh gS] ls vk;@isa’ku@ikfjokfjd isa’ku izkIr dj jgk gS\

14. laj{kd dh lHkh lk/kuksa ls okf"kZd vk; ------¼blesa osru lHkh izdkj dh isa’ku ikfjokfjd isa’ku] ih0,Q0 ij feyus okyk C;kt vkfn 'kkfey gS½

vkosnd ds gLrk{kj@vaxwBs dk fu’kku

'kiFk eSa] Jhefr@dq0------iq=@iq=h@iRuh@Jh------fuoklh------lR;fu"BkiwoZd ?kks"k.kk djrk@djrh gwa fd Åij fn;k x;k fooj.k esjs lokZsÙke Kku vkSj fo’okl d s vuqlkj Bhd ,oa lR; gSA ;fn mijksDr fooj.k esa ls dkbsZ Hkh rF; xyr ik;k tkrk gS] tks ljdkj dks esjh lHkh izdkj dh isa’ku@foÙkh; lgk;rk cUn djus o 12 izfr’kr C;kt lfgr izkIr dh xbZ jkf’k dks olwy djus dk vf/kdkj gksxkA lR;iku ¼lacaf/kr ljiap@okMZ ik"kZn@jktif=r vf/kdkjh }kjk vkosnd ds gLrk{kj@vaxwBs dk fu’kku uke------in ------fujkfJr cPpksa dks foÙkh; lgk;rk

Lohd`r vLohd`r

frfFk------gLrk{kj------31

vkosnu i= izkfIr jlhn Øekad------fnukad------

Jh@Jherh@dqekjh------iq=@firk@iRuh------fuoklh ------ls fnukad ------dks ckSuk HkÙkk gsrq QkeZ izkIr gqvkA

gLrk{kj------ftyk lekt dY;k.k vf/kdkjh 32

gfj;k.kk Je dY;k.k cksMZ }kjk lapkfyr Je dY;k.k ;kstuk,a iz'u1 gfj;k.kk ds dkj[kkuksa esa dke djus okys dkexkjksa ds fy, eq[; dY;k.kdkjh ;kstuk,sa D;k gS\ mrj gfj;k.kk ds dkj[kkuksa eas dke djus okys dkexkjksa ds fy, fuEufyf[kr dY;k.kdkjh ;kstuk,sa gSa%& 1) dkexkjksa dh yM+fd;ksa dh 'kknh ds mRlo ij 21000/- :0 dh jkf’k dU;knku ds :i esa iznku dh tkrh gAS 2) dkexkjksa dh lsok ds nkSjku nq?kZVuk esa viaxrk gksus ij :0 10000/- ls 15000/- rd dh lgk;rk ds :i esa udn jkf’k iznku dh tkrh gSA 3) e`rd vkS|ksfxd dkexkjksa dh fo/kokvksa@vkfJrksa dks :0 50000/- dh vkfFkZd enn o nkglaLdkj ds fy, :0 5000/- dh jkf’k iznku dh tkrh gSA ç’u2 gfj;k.kk ds dkj[kkuksa esa dke djus okys dkexkjksa ds fy, LokLF; lacaf/kr D;k ;kstuk, a gSa\ mrj ,slh laLFkk esa dk;Zjr Jfed tks bZ0,l0vkbZ0 ds rgr doj ugha gksrs dks fdlh nq?kZVuk eas vixa gksus ij lkdsr vLirky] p.Mheanhj] i apdqyk dh njksa ij d`=e vxa miYc/k djok;s tkrs gSa o mu Jfedksa dks tks fdlh Hkh dkj.k ls Jo.k 'kfDr [kks pqds gSa dks Jo.k e’khu miyC/k djokbZ tkrh gSA blds vfrfjDr VªkbZ lkbZdy] MsUVy ds;j gsrw 1200 :0 rd ,ao utj ds p’eksa ds fy, 500 :0 rd dh foRrh; lgk;rk iznku dh tkrh gSA ç’u3 gfj;k.kk ds dkj[kkuksa esa dke djus okys dkexkjkas ds cPpksa ds fy, D;k lqfo/kk,a gSa\ mrj 1) dkexkjksa ds cPpksa dks 8oha ikl djus ds i'pkr~ Ldwy eas vkxs i<+kbZ tkjh j[kus ij 9oha] 10oh]a +1, ,oa +2 rFkk LukrdksRrj d{kkvksa rd o fofHkUu dkslksZ esa 50% vad ;k mlls vf/kd izkIr djus ij de&ls&de 2000 o vf/kd ls vf/kd 12000 :0 dh jkf’k Nk=o`fr ds :i esa iznku dh tkrh gSA 2) 5000 :0 rd ekfld osru ikus okys Jfedksa dh yM+fd;kas ds fy, ikapoha d{kk ls vkBoha d{kk rd Ldwy dh onhZ] fdrkcsa o dkfi;ka vkfn [kjhnus grsw 2000 :0 dh foRrh; lgk;rk iznku dh tkrh gSA 33

3) vkS|ksfxd Jfedksa ds cPpkas o ifjokj ds lnL;ksa dks flykbZ] d<+kbZ] cqukbZ] vkpkj cukus] tSe cukus] eksecRrh cukus rFkk easgnh yxkus vkfn dk izf’k{k.k nsus ds fy, gfj;k.kk jkT; esa Qjhnkckn] /kk:gsM+k] cgknqjx<+] jksgrd] fglkj] pj[kh nknjh ¼fHkokuh½ vkj iSapdqyk esa nl Je dY;k.k dsUnz pyk, tk jgs gSaA ç’u4 gfj;k.kk Je dY;k.k cksMZ dh eq[; eU=h Je iqjLdkj ;kstuk D;k gS\ mrj eq[; eU=h Je iqjLdkj ;kstuk ds rgr esgurh dk;Zdq’ky ,oa oQknkj Jfedksa ¼iq:"k ;k L=h½ dks de ls de 20000 :0 o vf/kd ls vf/kd ,d yk[k :0 rd dh jkf’k ds iqjLdkj i znku fd, tkrs gSaA ç’u5 gfj;k.kk esa Jfed dks dk;Z LFky rd vkus tkus dh D;k lqfo/kk miyC/k gS\ mrj Jfed dks ftudh ekfld vk; 5000 :0 rd gS dks 2500/- :0 rd dh u;h lkbZdy cksMZ dh rjQ ls [kjhn dj miyC/k djokbZ tkrh gSA ç’u6 D;k gfj;k.kk esa Jfed dks Hkze.k HkÙkk feyrk gS\ mrj gk¡] Jfed dks muds ifjokj lfgr Kku ,oa vkuUn Hkze.k ds fy, 50 iSls izfr fd0eh0 izfr ;k Hkkjrh; jsy dk lk/kkj.k fjtosZa’ku dk fdjk;k vnk fd;k tkrk gS o /kkfeZd LFkkuksa ds Hkze.k ij mDr ds vfrfjDr 50 :0 izfr Jfed dks izfr fnu ;k vf/kdre 250 :0 rd izfr fnu ds fglkc ls Bgjus o [kkus gsrw miyC/k djok;s tkrs gSaA ç’u7 gfj;k.kk ds dY;k.kdkjh ;kstukvksa ds ykHk ds fy, dkSu ik= gS\ mrj gfj;k.kk Je dY;k.k cksMZ }kjk lapkfyr ;kstukvksa ds ykHk ds fy, ogh Jfed ik= gS ftudk va’knku iatkc Je dY;k.k fuf/k vf/kfu;e] 1965 ds vUrxZr cksMZ esa izkIr gksrk gS A lkb Zdy rFkk yM+ fd;k sa dks onhZ o fdrkcsa vkfn nuss okyh nks ;ks tukvk sa es a 5000 :0 ekfld osru ikus okys rFkk 'ks"k ;kstukvksa esa 15000 :0 rd ekfld osru ikus okys Jfedkas dks cksMZ dh vU; ;kstukvksa dk ykHk iznku fd;k tkrk gSA 34

gfj;k.kk esa Hkou ,oa vU; fuekZ.kdkfj;ksa esa yxs dkexkjksa o etnwjksa dks Hkou fuekZ.k deZdkj dY;k.k cksMZ }kjk D;k lgk;rk nh tkrh gSA

ç’u1 gfj;k.kk esa Hkou ,oa fuekZ.k dk;ksZa esa yxs dkexkjksa o etnwjksa dks Hkou fuekZ.k de Zdkj dY;k.k cksMZ }kjk lgk;rk fdl izdkj nh tkrh gS\ mrj gfj;k.kk esa Hkou fuekZ.k o etnwjksa dks cksMZ }kjk nh tkuh okyh lqfo/kk,sa rc feyrh gaS tc dkexkj o etnwj cksMZ }kjk iw.kZ thoudky ds fy, fu/kkZfjr Qhl 25 :0 vkjS 5 :0 dk izfr ekg lg;ksx fn;k tkrk gSA ç’u2 gfj;k.kk esa dkexkj dh csVh dh 'kknh ij D;k jkf’k nh tkrh gS\ mrj gfj;k.kk esa dkexkj dh csVh dh 'kknh ij 21,000/- :0 dh udn jkf’k nh tkrh gSA ç’u3 gfj;k.kk esa dkexkj o mlds ifjokj ds bZykt ds fy, D;k en~n dh tkrh gS\ mrj gfj;k.kk esa dkexkj o mlds ifjokj dks o"kZ esa rhl gtkj :0 eq¶r bZykt rFkk laØkRed jksxksa ds bZykt ij ,d yk[k :0 rd dk Hkxrkuq fd;k tkrk gSA ç’u4 gfj;k.kk esa dkexkj etnwjksa dks edku dh [kjhn o fuekZ.k ds fy, D;k fn;k tkrk gS\ mrj gfj;k.kk esa dkexkj etnwjksa dks edku dh [kjhn o fuekZ.k gsrw ,d yk[k :0 lk/kkj.k fdLrksa ij fey ldrs gSA ç’u5 gfj;k.kk esa dkexkj ds cPpksa dks Nk=o`fr ds :i esa lkyuk jkf’k fdruh fey ldrh gS\ mrj gfj;k.kk esa dkexkj ds cPpksa dks Nk=o`fr f’k{kk gsrw 12,500 rd dh jkf’k fey ldrh gSA ç’u6 gfj;k.kk esa vkStkjksa dh [kjhn ds fy, fdruk _.k feyrk gS\ mrj gfj;k.kk esa vkStkjksa dh [kjhn ds fy, 5,000 :i;s rd dk _.k feyrk gSA 35

ç’u7 gfj;k.kk esa LFkkbZ rkSj ij vi ax gksus ij fdruk HkÙkk fn;k tkrk gS \ mrj gfj;k.kk esa dkexkj dks 30,000 :0 dh vuqxzg jkf’k ds vfrfjDr v}jax] dSUlj] Vh-oh-] nq?kZVuk vkfn gksus ij 300 :0 izfr ekg feyxsaA ç’u8 gfj;k.kk esa dkexkj dh e`R;q ij ifjokj dks D;k lgk;rk feyrh gS\ mrj gfj;k.kk esa dkexkj dh izkd`frd e`R;q ij mlds mrjkf/kdkjh@vkfJr dks 75,000 :0 vkSj dk;Z ds nkSjku e`R;q gkuss ij ,d yk[k iPphl gtkj :0 fn;s tkrs gSaA ç’u9 gfj;k.kk esa dkexkj dks fpfdRl;k lgk;rk D;k nh tkrh gS\ mrj gfj;k.kk esa dkexkj dks gLirky esa fcekjh ds nkSjku nkf[ky gksus ij igys ikap fnukas ds fy, 200 :0 fn;s tkrs gSa vkSj vfrfjDr fnuksa ds fy, 20 :0 izfr fnu vkSj T;knk ls T;knk ,d gtkj :0 fn;s tkrs gSAa ç’u10 D;k gfj;k.kk esa dkexkj dh e`R;q ij ifjokfjd isa’ku feyrh gS\ mrj gk¡! gfj;k.kk esa dkexkj dh e`R;q gksus ij mldh isa’ku dk 50% isa’ku Hkksxh ds mrjkf/kdkjh dks feyrk gSA ç’u11 gfj;k.kk esa dkexkj dh e`R;q ij vafre laLdkj gsrw D;k fn;k tkrk gS\ mrj gfj;k.kk esa dkexkj dh e`R;q ij vafre laLdkj ds fy, 5,000 :i;s fn;s tkrs gSA ç’u12 gfj;k.kk esa D;k 60 o"kZ dh vk;q mijkUr izfr ekg isa’ku feyrh gS\ mrj gk¡! gfj;k.kk esa 60 o"kZ dh vk;q mijkUr 500 :0 izfr ekg isa’ku feyrh gSA 36

jk'ku dkMZ iz'u1 jk’ku D;k gS\ mrj jk’ku dk vfHkizk; gS&ih-Mh-,l- oLrq,a xsgw¡] phuh] fefÍ dk rsy bR;kfnA iz'u2 jk’ku dkMZ D;k gS\ mrj jk’ku dkMZ [kk| ,oa vkiwfrZ foHkkx }kjk tkjh fd;k x;k og dkMZ gS ftldk iz;ksx mfpr ewY;ka s dh nqdkuksa ls ¼jk’ku fMIiks½ ljdkj }kjk fu/kkZfjr ewY; ij jk’ku o oLrqvksa dks [kjhnus ds fy, izfrekl fd;k tkrk gSA iz'u3 jk’ku dkMZ cuokus dk ik= dkSu gS\ mrj jkT; esa LFkkbZ :i ls jgus okyk O;fDr jk’ku dkMZ cuokus dk ik= gSA iz'u4 jk’ku dkMZ dSls cuok;k tkrk gS\ mrj jk’ku dkMZ ljdkj }kjk fu/kkZfjr Mh&I QkeZ Hkjdj curk gS] ftlesa ifjokj dk iwjk fooj.k gksrk gSA jk’ku dkMZ ls lacfU/kr QkeksZ dks foHkkx dh oSclkbZV haryanafood.gov.in ls MkÅuyksM fd;k tk ldrk gSA iz'u5 D;k jk’ku dkMZ esa u;k uke 'kkfey fd;k tk ldrk gS\ mrj gk¡] jk’ku dkMZ esa u;k uke fu/kkZfjr QkeZ Hkjdj lEefyr fd;k tk ldrk gSA iz'u6 D;k jk’ku dkMZ ls iqjkuk uke gVk;k tk ldrk gS\ mrj gk¡] jk’ku dkMZ ls ljdkj }kjk fu/kkZfjr QkeZ Hkjdj iqjkuk uke gVk;k tk ldrk gSA iz'u7 D;k jk’ku dkMZ esa fuokl LFkku dk irk cnyk tk ldrk gS\ mrj jk’ku dkMZ esa fuokl LFkku dk irk fu/kkZfjr QkeZ Hkjdj cnyk tk ldrk gSA iz'u8 D;k jk’ku dkMZ leiZ.k djus mijkUr nwljs LFkku ij u;k jk’ku dkMZ cu ldrk gS\ mrj fujLrh izek.k i= fn[kkus ij u;k jk’ku dkMZ cu ldrk gSA iz’u9 jk’ku dkMZ cuokus ds fy, ljdkj }kjk fu/kkfjZr Qhl D;k gS\ mrj jk’ku dkMZ cuokus ds fy, ljdkj }kjk 10 :i;s dh Qhl fu/kkZfjr dh xbZ gSA 37 iz’u10 D;k jk’ku fMIiw cnyk tk ldrk gS\ mrj gk¡! jk’ku dkMZ /kkjd viuk jk’ku fMIiw cny ldrk gSA iz’u11 jk’ku dkMZ dkSu cukrk gS\ mrj jk’ku dkMZ [kk| ,oa vkiwfrZ foHkkx }kjk cuk;k tkrk gSA jk’ku dkMZ ls lEcfU/kr fofHkUu dk;ksZa ds fy, le; lhek

Øe fo"k; dke fu/kkZfjr ftl izkf/kdj.k dks la[;k le; f’kdk;r dh tk ldrh gSA 1. u;s jk’ku dkMZ cuokus ds fu/kkZfjr QkeZ 15 fnu ftyk [kk| ,oa Mh&I izkIr gksus ij tkjh djus dk le; lIykbZ fu;a=d 2. jk'ku dkMZ fujLrh djus mijkUr u;k jk’ku 7 fnu ftyk [kk| ,oa dkMZ tkjh djus dk le; lIykbZ fu;a=d 3. jk'ku dkMZ dh nwljh izfr tkjh djokus dk 7 fnu ftyk [kk| ,oa le; lIykbZ fu;a=d 4. ifjokj ds lnL; dk uke 'kkfey o gVokus 7 fnu ftyk [kk| ,oa ij tkjh dk le; lIykbZ fu;a=d 5. mlh {ks=kf/kdkj esa irk cnyokus ij tkjh 7 fnu ftyk [kk| ,oa dk le; lIykbZ fu;a=d 6. jk’ku dkMZ fMIiw o irk cnyokus ij tkjh 7 fnu ftyk [kk| ,oa dk le; lIykbZ fu;a=d 7. fujLrh izek.k i= tkjh djokus dk le; 3 fnu ftyk [kk| ,oa lIykbZ fu;a=d 38

FORM - 1

kAD~Y lVm PITu ^ IVbAG, HIRYAnA pAM^ Fi – 1 Nl/FUILiKEW/INR_TiKRn KE aA~AR PR RAsN KAF^ KE ILl aAVEDN PQ SRYAIPT pOWO PuRA IVVRn _P"W aXROm MmE bREm ICPKAlm 1. aAVEDK KA NAM ...... 2. MATA/IPTA/PIT KA NAM ...... 3. gR KA PRAu PTA% MKAN Nm...... VAF^ Nm ...... SeDWR...... MOHYLA/GLi ...... GAmV/sHR ...... pON N...... m 4. OYVSAY lVm PD PTA SIHT ...... 5. GeS KNeDsN He YA NHim ...... YID He TO @PbODTA Ø0...... ISLe.FROm Ki S>YA ...... GeS lJ$Sie KA NAM ...... 6. DYA aAVEDK YA @SKE PIRVAR KA KO`^ SD_Y aAYKRDATA He YA NHim ...... YID He TO @SKA IVVRn% NAM ...... OYVSAY...... PeN Nm0...... 7. Sbi _QOTOm SE PIRVAR Ki VAIh^K aAY ...... 8. PIRVAR KE SD_YOm KA Pun^ IVVRn% Ø.Sm. NAM aAYU IPTA/PIT KA aAVEDK KE _tAN/RATY JHAm SE aAl NAM SAt SmBm~ Hem, aANE IK ITIt

ITIt...... aAVEDK KE H_TAXR/INsAN aGuwAm gOhnA Mem lTD~ gOhnA KRTA Hvu IK% 1. PuV^ P`"w PR Di G`^ SuCNA SHi He| 2. Mem bART KA NAGIRK Huv| 3. KALM 8 MEm sAIML SD_YOm MmE SE IKSi bi SD_Y KE NAM PuRE bART Vh^ MEm IKSi bi _tAN PR KO`^ RAsN KAF^ NHim BNA HUaA He aoR N Hi IKSi a$Y RAsN KAF^ ME m YH NAM DJ^ He| N Hi KO`^ SD_Y SENAS E RAsN LETA He| 4. PuV^ P`"w PR IDl Gl PTE PR Mem ...... Vh^ SE RHTA Huv| 5. `SSE PV^u PAm C VhO^ m ME m INENILIkT _tANOm PR RHA Hvu - 39

PTA...... PTA...... PTA...... 6. ÅPR IDl Gl PTE PR bi MemNE aPNE NAM SE YA aPNE PIRVAR KE IKSi SD_Y KE NAM SE RAsN KAF^ NHim BNVAYA| Mme YH bi CYAN KRTA Huv IK MERE }ARA JO gOhnA Ki G`^ He VH IBYKUL SRY V wiK H|e GLT CYANi KE KARn DOhi PAl JANE PR Mem D.FNiY INYMOm KE THT SJA KA bAGi HvuGA|

sPt KTA^, aAVEDK KE H_TAXR V ITIt SRYAIPT KRNE VALE OYIDT KE H_TAXR, PD, MOHR TtA ITIt ...... GLT SuCNA DN E E VALE aAVEDK TtA aAVEDN PQ KO GLT

YA PIRVAR pAM^ MEm IDYE GYE PTE PR NHim RHTA| INRiXK KE H_TAXR TtA ITIt JARi IKYE GYE RAsN KAF^ Ki Sm>YA ...... VAF^ N.m ...... MKAN Nm...... Fi-4 N...... m YuINW...... #ni...... E

RAsN KAF^ BNANE VALE aI~KARi KE H_TAXR IJSNE IVTRn KAF^ JARi KRNE KM^CARi KE H_TAXR `$DrAJ Fi-4 RIJ_WR MEm VALE aI~KARi KE H_TAXR ITIt SIHT NAM DJ^ IKYA He| ITIt SIHT ITIt SIHT RAsN KAF^ PrAIT KRNE VALE KE H_TAXR ITIt SIHT 40

kAD~Y lVm PITu ^ IVbAG, HIRYAnA pAM^ Fi – 1 INR_TiKRn PrMAn PQ K E aA~AR PR RAsN KAF^ BNVANE KE ILl aAVEDN PQ PuRA IVVRn _P"W aXROm MmE bREm SRYAIPT pOWO ICPKAlm 1. aAVEDK KA NAM ...... 2. MATA/IPTA/PIT KA NAM ...... 3. gR KA PRAu PTA% MKAN Nm...... VAF^ Nm ...... SeDWR...... MOHYLA/GLi ...... GAmV/sHR ...... pON N...... m 4. OYVSAY lVm PD PTA SIHT ...... 5. GeS KNeDsN He YA NHim ...... YID He TO @PbODTA Ø0...... ISLe.FROm Ki S>YA ...... GeS lJ$Sie KA NAM ...... 6. DYA aAVEDK YA @SKE PIRVAR KA KO`^ SD_Y aAYKRDATA He YA NHim ...... YID He TO @SKA IVVRn% NAM ...... OYVSAY...... KUL VAIh^K aAY ...... PeN Nm0...... 7. Sbi _QOTOm SE PIRVAR Ki VAIh^K aAY ...... 8. PIRVAR KE SD_YOm KA Pun^ IVVRn% Ø.Sm. NAM aAYU IPTA/PIT KA aAVEDK KE _tAN/RATY JHAm SE aAl NAM SAt SmBm~ Hem, aANE IK ITIt

SmLXN MLu INRi_TiKRn PMAnr PQ

ITIt...... aAVEDK KE H_TAXR/INsAN aGuwAm gOhnA Mem lTD~ gOhnA KRTA Hvu IK% 1. PuV^ P`"w PR Di G`^ SuCNA SHi He| aAVEDK KE H_TAXR ITIt SIHT SRYAIPT KRNE VALE OYIDT KE H_TAXR, PD, MOHR TtA ITIt ...... GLT SuCNA DN E E VALE aAVEDK TtA aAVEDN PQ KO GLT

KEVL KAYA ^LY P rYOG K E ILl INRiXn KRNE VALE KM^CARi/aI~KARi Ki SRYAIPT IRPOW^ aAJ IDNAmK ...... KO aAVEDK KE PF+OSi #i/#iMIT ...... INVASi MKAN Nm ...... SE SmPK ^ IKYA GYA| aAVEDN PQ MEm IDYE GYE IVVRn SHi PAYE Gl| IDYE GYE PTE PR RH RHE OYIDTYOm KA IVVRn INEN aNUSAR He- OY_K BPCE IssU KLU SD_Y

YA PIRVAR pAM^ MEm IDYE GYE PTE PR NHim RHTA| INRiXK KE H_TAXR TtA ITIt JARi IKYE GYE RAsN KAF^ Ki S>YAm ...... VAF^ N...... m MKAN Nm...... Fi-4 N...... m YuINW...... #ni...... E

RAsN KAF^ BNANE VALE aI~KARi KE H_TAXR IJSNE IVTRn KAF^ JARi KRNE KM^CARi KE H_TAXR `$DrAJ Fi-4 RIJ_WR MEm VALE aI~KARi KE ITIt SIHT NAM DJ^ IKYA He| H_TAXR ITIt SIHT ITIt SIHT RAsN KAF^ PrAIT KRNE VALE KE H_TAXR ITIt SIHT 42

kAD~Y lVm PITu ^ IVbAG, HIRYAnA pAM^ Fi – 1A RAsN KAF^ KE ILl aAVEDN PQ IWIPni – aAVEDK ÑIYA aI$TM P`"w PR aNDsOU E m KO DE kE| m

ÑIYA @ICT KO || KRE|m 1. INR_TiKRn PrMAn PQ KE aA~AR PR NYA RAsN KAF^ SRYAIPT pOWO 2. FUILiKEW RAsN KAF^ ICPKAlm 3. RAsN KAF^ MEm aITIRDT SD_Y KA NAM JOF+NE/KAWNE HETU 4. RAsN KAF^ MmE PTA BDLVANE HTEU 5. RAsN KAF^ MmE PTA V IFPO~ARK KA PIRVT^N KRN E HETU 6. INR_TiKRn PMAn PQ PrrAIT KRNE HETU

PuRA IVVRn _P"W aXRO m ME m bREm 1. aAVEDK KA NAM ...... 2. MATA/IPTA/PIT KA NAM ...... 3. gR KA PuRA PTA%- MKAN Nm...... VAF^ Nm ...... SeDWR...... GAmV ...... KALONi/MOHYLA/GLi N...... m 4. _tA`^ FAK PTA%- MKAN Nm...... VAF^ Nm ...... SeDWR...... GAmV ...... KALONi/MOHYLA/GLi N...... m 5. BDLE HlU _tA`^ PTE KA IVVRn%- MKAN Nm...... VAF^ Nm...... SeDWR...... GAmV ...... KALONi/MOHYLA/GLi Nm...... 6. OYVSAY lVm PD PTA SIHT ...... 7. GeS KNeDsN He YA NHim ...... 8. DYA aAVEDK YA @SKE PIRVAR KA KO`^ SD_Y aAYKRDATA He YA NHim ...... YID aAYKRDATA He, TO @SKA IVVRn%- NAM ...... OYVSAY...... KUL VAIh ^K aAY...... 9. Sbi _QOTOm SE PIRVAR Ki VAIh^K aAY ...... 10. PIRVAR KE SD_YOm KA Pun^ IVVRn% Ø.Sm. NAM aAYU IPTA/PIT aAVEDK KE _tAN/RATY JHAm KALM “k” MEm aITIRT KA NAM SAt SmBm~ SE aAl Hem, aANE OYIDT KA NAM JO IK ITIt KWVAYA JANA He atVA sAIML IKYA JANA He| K k G g F. C c 1 2 3 43

4 5 6 7 8 9 10

ITIt...... aAVEDK KE H_TAXR/INsAN aGuwAm

gOhnA Mem lTD~ gOhnA KRTA Hvu IK%- 1. PuV^ P`"w PR Di G`^ SuCNA SHi He| 2. PuV^ P`"w KE KALM – 10 MmE sAIML SD_YOm MmE IKSi bi SD_Y KE NAM PuRE bART Vh^ MmE IKSi bi _tAN PR KO`^ RAsN KAF^ NHim BNA HUaA He aoR N Hi IKSi a$Y KE RAsN KAF^ MmE YH NAM DJ^ IKYE HUl Hem| 3. PuV^ P`"w PR KALM - 10 MEm SD_Y SURXA SNAE KE INID^"W kAD~Y V_TaOU m KO JARi NHim KRVATE aoR N Hi `N SD_YOm KA NAM bART KE IKSi bi @PbOG KAF^ MmE DJ^ He| 4. PuV^ P`"w MEm VIn^T KO`^ bi SD_Y IKSi bi HO_WL/BOIF^mG HA@S SE INYIMT bOJN NHim LETA He aoR N Hi @NKE NAM HO_WL/BOIF^mG HA@S }ARA BNVAl Gl RAsN KAF^ MEm DJ^ He| 5. MERE atVA MERE PIRVAR KE SD_Y #i/#iMTi KE PAS GeS KNeDsN Nm ...... lK YA DO ISLE.FR KA He| YA 6. MREE YA MERE PIRVAR KE IKSi SD_Y KE PAS GeS KNeDsN NHim He| 7. Mem aPNE Sbi PIRVAR KE SD_YOm SIHT MuLT% VIn^T MKAN Mm ERHTA Hv u| 8. IJS RAsN KAF^ KE THT/FUILiKEW RAsN KAF^ KE ILl aAVEDN IKYA JA RHA He TO VH VA_TV MmE MAS ...... 20.... KE DoRAN GUM HUaA He YID VH RAsN 44

KAF^ IML GYA TO @SE kADY lVm PuIT^ IVbAG KE KAYA^LY MEm JMA KRVA IDYA JAlGA TtA IKSi bi TRH PrYOG MmE NHim LAYA JAlGA| 9. PuV^ P`"w KE KALM – 10 MEm VIn^T SD_Y abi bi IDYE GYE PTE PR RHTE Hme TtA Sbi NAM GUM HYEU KAF^ PR aA~AIRT He| 10. PuV^ P`"w KE KALM – 10 ME m VIn^T SD_YOm KE GrUP pOWO Ki DO PASPOW^ aAKAR Ki PrITYAv SmLXN Hem|

SRYAIPT KRNE VALE OYIDT KE aAVEDK KE H_TAXR-INsAN amGuwA H_TAXR lVm PD, MOHR TtA ITIt SIHT| ...... 1 GLT SuCNA DNEE VALE aAVEDK TtA aAVEDN PQ KO GLT

(aAVEDK KE ILl aNUDEs/IHDAYTEm) 1. aPun^ aAVDN PQ RE í KR IDYA JAlGA| 2. aAVEDN PQ KO SUPAwY ILkAVW MmE sU%

FUILiKEW RAsNKAF^/PTA BDLVAN/JMAE KRVAYE Gl RAsN KAF^ KE PrMAn PQ PrAIT KRNE KE ILl IFPO~ARK Ki SRYAIPT/Rí IRPOW^| KAF^ ~ARK ITIt IJS RAsN KAF^ YuINW MKAN/VAF^ @ICT MuYY KA NAM IDN amITM Ki amITM Sm>YA DUKAN Ki PuIT^ Ki G`^ PmJiKRn PrAI~—T He Sm>YA Sm>YA 1 2 3 4 5 6

PrMAInT IKYA JATA He IK MmeNE @PRODT aAVEDK KE RAsN KAF^ KO aPNE PmJi—T RIJ_WR SE Rí KR IDYA He| Rí RAsN KAF^ KE a$TG^T RAsN MAQA JARi NHim Ki JAlGi aoR YID `Si PrKAR KA KAF^ IFPO MmE Pr_TUT IKYA JATA He TO Mme @SE kAD~Y lVm PuIT^ IVbAG KE SEBI$~T KAYA^LY Mm E JMA KRVA DuGA|m IFPO HOYFR KE H_TAXR IDNAmK V MOHR SIHT FUILiKEW RAsN KAF^ KE ILl Fi-4 RIJ_WR KEE RkRkAV K ILl INYUDT KMCARi Ki SRYAIPT IRPOW^ FUILiKEW RAsN KAF^ JARi KRNE KE ILl @PRODT IVVRn FUILiKEW RAsN KAF^ Ki JUMA^NA piS KAF^ Sm>YA, MKAN Nm SIHT SRYAIPT IKYA GYA TtA Sm>YA ...... IDNAmK...... VH Fi-4 RIJ_WR MEm DJ^ KE aNU

(KEVL KAYA ^LY P rYOG K E ILYE – aAVDKE }ARA N bRA JAYE) INRiXn KRNE VALE KM^CARi/aI~KARi Ki SRYAIPT IRPOW^ aAJ IDNAmK ...... KO aAVEDK KE PF+OSi #i/#iMIT ...... INVASi MKAN Nm ...... SE SmPK ^ IKYA GYA| aAVEDN PQ MEm IDYE GYE IVVRn SHi PAYE Gl| IDYE GYE PTE PR RH RHE OYIDTYOm KA IVVRn INEN aNUSAR He- OY_K BPCE IssU JOF+

IJN KARnOm SE SRYAIPT NHim IKYA GYA 1. ______2. ______3. ______

INRiXK KE H_TAXR IDNAmK MOHR lVm NAM SIHT| JARi IKYE GYE RAsN KAF^ Ki S>YAm ...... VAF/MKAN N...... m YuINW...... NYE/FUILiKEW/PrIT_tAPN/aITIRDT NAM KWVAN/PTAE BDLN E lVm RAsN KAF^ JMA KRVANE KA `$DrAJ Fi-4 RIJ_WR MEm IKYA GYA He|

RAsN KAF^ BNANE VALE aI~KARi KE H_TAXR IJSNE IVTRn KAF^ JARi KRNE KM^CARi K E H_TAXR `$DAJr Fi-4 RIJ_WR MEm VAL E aI~KARi KE NAM DJ^ IKYA H|e H_TAXR

RAsN KAF^ PrAIT KRNE VALE KE H_TAXR ITIt SIHT

PrAITi RSiD Fi-2 KA ØMAmK ...... IDNAK...... m aAVEDK KA NAM ...... MKAN Nm ...... VAF^/SeDWR...... GAmV/KALONi ...... BULANE Ki ITIt ......

aAVEDK PQ PrAIT KTA^ KE H_TAXR NAM PD SIHT 47

aITIRDT SD_YOm MuYY...... SIHT SRYAIPT GrPU SEEVA Mm pOWO ICPKAlm SHAYK kAD~Y lVm PuIT^ aI~KARi/ INRiXK kAD~Y lVm PuIT^ ...... IVhY% RAsN KAF^ ME m aITIRDT NAM DJ^ KRNE KE ILl aAVEDN PQ| #iMAN Ji, INVEDN He IK MER E RAsN KAF^ Nm ...... YuINW ...... Fi-4 Nm...... RIJ_WªEsN N...... m #E ni ...... MEm INENILIkT SD_YOm KE NAM DJ^ KRNE Ki —PA KRmE| M uL RAsN KAF^ TtA aITIRDT SD_YO m SIHT GrUP pOWO Ki lK PrIT aLG SE SAt SmLXN He| SD_Y KA NAM aAYU aAVEDK KE SAt SmBm~ KARn

J$M PrMAn PQ/MuL INR_TiKRn PrMAn PQ SAt SmLXN H|e

aAVEDK KA NAM V H_TAXR V PTA ITIt SIHT SRYAIPT KRNE VALE OYIDT KE H_TAXR, PD, MOHR TtA ITIt

KEVL KAYA ^LY PrYOG K E ILl RAsN KAF^ Nm ...... YuINW ...... Fi-4 Nm...... RIJ_WªEsN Nm ...... #Eni ...... aAVzYK `$DrAJ Fi-4 V RAsN KAF^ Mm E KR IDYA GYA He|

INRiXK KE ITIt SIHT H_TAXR

MuL RAsN KAF^ PrAIT KTAK^ E H_TAXR 48

MuYY...... SEEVA Mm SHAYK kAD~Y lVm PuIT^ aI~KARi/ INRiXK kAD~Y lVm PuIT^ ...... IVhY% RAsN KAF^ ME m PTA BDLVANE KE ILl aAVEDN PQ| #iMAN Ji, INVEDN He IK MemNE aPNA INVAS _tAN BDL ILYA H| Meem aB INENILIkT PTE PR RHTA Hu|v `SILYE MRE E ML u RAsN KAF^ Nm...... YuINW ...... Fi-4 Nm...... #ni...... E MmE NYE PTE KA `$DrAJ IKYA JAYE| MKAN Nm GLi/MOHYLA/KALONi VAF^ Nm GAV/sHRm ______

SmLXN% NYE PT E KA SBuT/Mu L RAsN KAF^ aAVEDK KA NAM V H_TAXR

SRYAIPT KRNE VALE OYIDT KE H_TAXR, PD, MOHR TtA ITIt

VAF^ PIRVT^N/IFPO ~ARK KE KAY^ XEQ BDLNE Ki I_tIT ME m IFPO~ARK Ki IRPOW^| RAsN KAF^ N...... m YuINW...... Fi-4 Nm...... RIJ_WªEsN N...... m #Eni...... YH KAF^ MNem E aPNE RIJ_WªEEsN RIJ_WR S KAW IDYA He|

IFPO~ARK KE H_TAXR V MOHR ITIt SIHT|

KEVL KAYA ^LY PrYOG K E ILYE RAsN KAF^ Nm ...... YuINW ...... Fi-4 Nm...... RIJ_WªEsN Nm ...... #Eni ...... aAVzYK `$DrAJ Fi-4 V RAsN KAF^ Mm E KR IDYA GYA He|

INRiXK KE ITIt SIHT H_TAXR MuL RAsN KAF^ PrAIT KTAK^ E H_TAXR 49

MuYY...... SEEVA Mm SHAYK kAD~Y lVm PuIT^ aI~KARi/ INRiXK kAD~Y lVm PuIT^ ...... IVhY% RAsN KAF^ ME m PTA BDLVANE KE ILl aAVEDN PQ| #iMAN Ji, INVEDN He IK MemNE aPNA INVAS _tAN BDL ILYA H| Meem aB INENILIkT PTE PR RHTA Hvu| `SILYE MERE MuL RAsN KAF^ N..m ...... YuINW ...... Fi-4 Nm...... #ni...... E MmE NYE PTE KA `$DrAJ IKYA JAYE| MKAN Nm GLi/MOHYLA/KALONi VAF^ Nm GAV/sHRm ______

SmLXN% NYE PT E KA SBuT/Mu L RAsN KAF^ aAVEDK KA NAM V H_TAXR

SRYAIPT KRNE VALE OYIDT KE H_TAXR, PD, MOHR TtA ITIt

VAF^ PIRVT^N/IFPO ~ARK K E KAY^ XEQ BDLNE Ki I_tIT ME m IFPO~ARK Ki IRPOW^| RAsN KAF^ N...... m YuINW...... Fi-4 Nm...... RIJ_WªEsN N...... m #Eni...... YH KAF^ MNem E aPNE RIJ_WªEEsN RIJ_WR S KAW IDYA He|

IFPO~ARK KE H_TAXR V MOHR ITIt SIHT|

KEVL KAYA ^LY PrYOG KE ILYE RAsN KAF^ Nm ...... YuINW ...... Fi-4 Nm...... RIJ_WªEsN Nm ...... #Eni ...... aAVzYK `$DrAJ Fi-4 V RAsN KAF^ Mm E KR IDYA GYA He|

INRiXK KE ITIt SIHT H_TAXR MuL RAsN KAF^ PrAIT KTAK^ E H_TAXR 50

MuYY......

SEEVA Mm SHAYK kAD~Y lVm PuIT^ aI~KARi/ INRiXK kAD~Y lVm PuIT^ ......

IVhY% RAsN KAF^ Rí KRVANE KE ILl aAVEDN PQ|

#iMAN Ji, INVEDN He IK Mem sHR/GAVm ...... cOF+KR ...... sHR/GAmV Mm E CLA GYA Huv| aT% MRAE YA RAsN KAF^ N...... m YINW ...... Fi-4 Nm...... RIJ_WªEsN Nm...... #ni...... ,E Rí KRKE PrMAn PQ JANi KRNE Ki —PA KRm|E M uL RAsN KAF^ SAt SmLXNH e|

aAVEDK KA NAM V H_TAXR V PTA ITIt SIHT

IFPO~ARK Ki IRPOW^| RAsN KAF^ N...... m YuINW...... Fi-4 Nm...... RIJ_WªEsN N...... m #Eni...... YH KAF^ MNem E aPNE RIJ_WªEEsN RIJ_WR S KAW IDYA He|

IFPO~ARK KE H_TAXR V MOHR|

KEVL KAYA ^LY PrYOG KE ILYE @DT RAsN KAF^ KAYA^LY IRKAF^ S E Rí KRKE PrMAn PQ JARi KR IDYA GYA He|

IRKAF^ SE Rí KRNE V PrMAn PQ JARi KRNE VALE INRiXK KE H_TAXR ITIt SIHT|

INR_TiKRn PrMAn PQ PrAIT KTA^ KE H_TAXR 51

ikuh dk duSD’ku iz’u1 miHkksDrk ls D;k vfHkizk; g S\ mrj tks O;fDr ikuh dk duSD’ku ysus ds fy, viuk izkFkZuk i= tu LokLFk; foHkkx dks nsrk gS og miHkksDrk dgykrk gAS iz’u2 ikuh duSD’ku ysus ds fy, miHkksDrk dks D;k&D;k nLrkost yxkus iM+rs gSa\ mrj 1. ljdkj }kjk fu/kkZfjr QkeZA

2. fuokl izek.k i=A

3. VsLV fjiksVZA

4. lqj{kk jkf’k dh jlhnA iz’u3 D;k vLFkkbZ ikuh dk duSD’ku fey ldrk gSS\ mrj gk¡] dksbZ Hkh O;fDr vLFkkbZ ikuh dk duSD’ku fu/kkZfjr QkeZ Hkjdj ys ldrk gSA iz’u4 duSD’ku ds fy, vkosnu i= dgka fn;k tkrk gSS\ mrj duSD’ku ds fy, vkosnu i= mi&e.My vf/kdkjh ¼tu LokLFk;½ ds dk;Zy; esa fn;k tkrk gSA iz’u5 ikuh duSD’ku ds fy, fu/kkZfjr Qhl D;k gS\ mrj xkeh.kz Lrj ij & ikuh dk duSD’ku ysus ds fy, 500 :I;s Qhl tek djokuh gksrh g SA y sfdu gfj;k.kk ljdkj us ekpZ 2013 rd ;g Qhl ekQ dh gqbZ gSA 'kgjh Lrj ij & ikuh dk duSD’ku ysus ds fy, 1000 :I;s Qhl tek djokuh gksrh g SA 52

APPLICATION FOR PRIVATE WATER CONNECTION IN URBAN AREA

To The SDE Public Health Engineering Sub-Division Sub Division No………….

Sir,

I need a metered private water connection from your distribution system into house no. ………………Situated near……………

1. The house is owned /not owned by me.

2. I undertake to act in accordance with the bye laws and regulations made by the department from time to time. I will not fix any hand pump and tap or pumping set on the supply main.

3. I agree that the PHED, without notice will have the power to disconnect the service pipe up to my premises, if it is considered fit, advisable and necessary to do so for any reason whatsoever.

4. I will provide all material and labour also and will pay the department, the required charges and also under take to pay the monthly consumption charges regularly.

Yours faithfully Dated ………………..

Signature of applicant

In case of tenant

I, the owner of the house No……………………. shall be responsible for all payments due against the private water connection. In case of non payment by the tenant, I have no objection giving in a connection to the said house.

House Owner’s Signature 53

Application Form for Water Supply/ Sewerage Connection (Urban)

Name of the Applicant:

Father’s / Husband’s Name:

Permanent Address:

Address of premises for which Connection Applied: Type of Connection Applied: (Domestic/ Commercial/ Industrial/ Size of Ferrule for Water Connection applied: (6mm/ 10mm/ 12mm/ 15mm/ 20mm) In case of Institutional/ Industrial/ Commercial connection quantity and nature of Sewerage to be disposed in Sewer: (70% of the water consumed) Proof of Residence / Identity Attached: Photostat Copy of Ration Card /Voter Identity Card Details of Connections: (if held by the applicant previously)

Details of Fee Deposited for Road-Cut: (if applicable) a) Certified that I am owner of the premises / building for which connection is applied. b) Certified that the information given in the Performa above is correct. If at any stage, any of above information is found wrong I will loose the right of continuing my connection and liable of the punishment as per rules of the department in force at the time. c) I agree to abide by the rules and regulations of the department in force from time to time.

Signature of the applicant 54

Report of the fitter / authorized person of the Department

The existing Water Supply / Sewerage line is of size ………………mm and is ……………. meters away from house of the applicant. Road ……………. meters wide requires to cut for giving connection.

Signature Name and Designation of Reporting Officer

Recommendation of the Junior Engineer

Ferrule connection of …………mm size from existing W/S line ………….. mm/ Sewerage connection in Manhole/ Oblique connection in ……………. mm sewer line recommended.

Date: Signature (Full Name of the Junior Engineer)

As recommended above …………mm ferrule connection / Sewer connection sanctioned.

Sub Divisional Engineer Public Health Engineering Sub Division ……………………………. Received a sum of Rs……………………. vide Receipt No……………….. dated ……………… on a/c of security/ connection fee charges. Entered in register page no……………………… The account no. of the consumer is……………………………….

Sub Divisional Engineer Public Health Engineering Sub Division …………………………… 55

fctyh duSD’ku iz’u1 fctyh miHkksDrk ls D;k vfHkizk; gS\ mrj tks O;fDr fctyh dk duSD’ku ysus ds fy, izkFkZuk i= fctyh foHkkx dks nsrk gS miHkksDrk dgykrk gAS iz’u2 fctyh duSD’ku ysus ds fy, miHkksDrk dks D;k&D;k nLrkost yxkus iM+rs gSa\ mrj 1. eyfd;r izek.k i=A 2. oksVj igpku i=A 3. jk’ku dkMZA 4. QksVkAs 5. ljdkjh txg gksus ij dCtk ;k vkaofVr iek.kz i=A 6. fdjk;knkj gksus dh fLFkfr esa ekfyd dk vukifÙk izek.k i=A 7. nks xokgksa vkSj muds fctyh fcy dh Nk;kizfr dkih;kaA 8. 'kgjh {ks= % jftLVªh dh dkih ;k edku fdjk;s dh fu/kkZfjr dkihA 9. xzkeh.k {k=s % edku dk yky Mksjk esa gksus dh ljiap }kjk rlnhdA iz’u4 fctyh duSD’ku QkeZ dh dher D;k gSS\ mrj fctyh duD’ku QkeSZ eq¶r esa feyrk gSA iz’u5 D;k fctyh dk yksM c

UTTAR HARYANA BIJLI VITRAN NIGAM LTD APPLICATION & AGGREMENT FORM IN RESPECT OF DOMESTIC/ NON- DOMESTIC SUPPLY (strike out whichever is not applicable) (For Office use only) Name of the Sub-Division: Application No.: Date of Receipt: (To be filed up by the applicant in Block letters in ink) 1. Applicant’s Name 2. Father’s name / Husband’s name 3. Full address of the premises at which supply is required. 4. Telephone No. (if any) 5. Permamnent Address (Residential) 6. Bank Account No. (if any) 7. Name of the Bank with address 8. Ration Card No./ Voter identity Card Any No./Pan One No. Driving License No. 9. Details of any other Category connection in the name of applicant (if any) Account No. Address 10. Details of any other connection in the same premises ( if any) 11. If tenant, landlord’s Name & Address 12. Category of connection (DS or NDS) 13. Type of connection (Temporary or Premanent) 14. Connected Load / Contract Demand, applied for 15. Voltage at which supply requires 16. Whether new connection , reconnection or extension/ 17. Existing Account No.(if any) ( for reconnection, extension / Date: Signature of Applicant:______57

Acknowledgement

Date Applicant’ Name Category of supply Application Nos.

(Signature of authorized officer)

Instruction for Applicants:- (i) Application No. shall be allowed by the cashier at the time of receipt of Application processing charges. (ii) Please furnish installation Test report issued by licensed electrical wiring contractor, after completion of installation giving full details of load/ machinery 58

DECLARATION

I [------], son/daughter/wife of [------], resident of [------], (hereinafter referred to as the “Applicant”, which term shall mean and include executors, administrators, heirs, successors and assignees), do hereby swear and declare as under. OR The [------], a company incorporated under the provisions of the companies Act-1956, a sole proprietorchip, a partnership, a partnership having its registered office at [------] (hereinafter referred to as “Applicant”, which expression shall unless repugnant to the context or meaning thereof, include its successors and assignees), do hereby swear and declare as under: 1. THAT the applicant is a legal occupant / owner / landlord of the premises at [------] in support of which the applicant has enclosed a proof of occupancy / owner ship. And, 2. THAT In case of tenant; (i) The Written consent of the Landlord of the Applicant’s taking of the said supply is enclosed herewith. Or (ii) The applicant is the lawful occupier of the premises, but has not been possible to obtain consent of landlord and the applicant hereby agrees to keep the supplier indemnified and harmless against all claims made and actions and proceedings initiated by the landlord or any person claiming through or under him by reason of the giving of electric connection by the supplier to the applicants. Indemnity bond duly executed on court paper of Rs. 15/- is attached. And, 3. That the applicant has requested the Uttar Haryana Bijli Vitran Nigam Ltd (UHBVN) (hereinafter referred to as the “Supplier”) to provide a service connection in the above- mentioned premises in the Applicant’s name for the purpose mentioned in the application & agreement form. And, 4. THAT the Applicant hereby further agrees and undertakes: (i) The applicant desires to have and agrees to take Electrical Supply for the purpose stated in the Application and Agreement form, from the supplier at the premises stated, not exceeding the sanctioned load of the installation. And, (ii) To indemnify the supplier against all proceedings, claims, demands, costs, damages, expenses that supplier may incur by reson of a freshservice connection to the Applicant. And, 59

(iii) That all the electrical work done within its / their premises are as per the provisions or Electricity Act 2003, and indemnify supplier against any loss to the applicant accrued on this account. Further, applicant agrees that if there is any harm / loss to the property of supplier, due to tha fault of the electrical network within the premises of the Applicant, all the liabilities shall have to be bome by the applicant Further, that the lift installed (if applicable) has been inspected and certified by the Lift Inspector and the all the fire safety norms have been complied with and the necessary fire clearance certificate (if applicable) has been issued by the competent authority. The applicant indemnifies the supplier against all proceedings, claims, demands, costs, damages, and expenses that supplier may incur by violation of the above regulations. And, (iv) To accept and abide by all norms, Conditions of supply, including Schedules of Tariffs, Schedule of General and Miscellaneous Charges, as per the provisions of The Electricity Act-2003 and other applicable laws in force, Rules / Regulations / Orders / Directives / Notification issued and enforced under applicable laws by HERC / CEA /Govt. of India / Govt. of Haryana and any other instruction / circulars issued by suppliers / Nigam from time to time, and as amended from time to time, for equitable and efficient distribution of electric energy. And, (v) To pay ffor the said supply in accordance will the reievant applicable Schedule of tariffs and also to pay all such other proper charges (including MMC, if applicanle), as may become due, to the supplier, from time to time at rates laid down in the Standard Schedule of General & Miscellaneous Charges prescribed by the supplier. And, (vi) To pay taxes / duties as may be levied on the sale of electricity to the applicant by the supplier. And, (vii) Require the supplier to supply with the necessary meter/meters on hire in terms of the section-55 of the Electricity Act-2003. The applicant agrees to give the Supplier such Meter Security and Monthly meter service Charges, as may be required for the price of the meter/meters, whenever called upon to do so. In case, meter is not readily available, the applicant may be permittedto arrange own meter of standard specification as approved by the supplier. And, (viii) To be responsible for the safe custody of the meters, CTs, PTs, Cables etc provided by supplier and in case there is any damage to these equipments due to resons attributable to the applicant, the same shall be chargeable to the Applicant. Further all repercussions, on account of breakage of seals of meter etc, Direct / dishonest / abstraction of energy shall be to the account of 60

applicant as per the extant rules of supplier. And, (ix) To allow clear and un-encumbered access to the meter for the purpose of meter reading and it’s checking. And, (x) That the applicant shall have no objection at any time to the rights of the supplier to supply energy to any other consumer from the service line or apparatus installed on the applicants premises. And, (xi) That the supplier shall not be load responsible for any interruption / diminution of supply beyond its control. And, (xii) That the supply shall be used for the purpose that it has been sanctioned by the supplier and shall not be misused in any way to serve any other purpose. (xiii) That the supply shall not be expended/sublet to any other premises. And, (xiv) That the Applicant’s industry/trade has not been declared to be obnoxious, hazardous / pollutant by any Government agency and that no court orders are being infringed by grant of applied electricity connector.Applicant premises. And, (xv) That grant of electricity connection will not confer any legal right for regularization of building/land use in respect to the electricity connection provided at the Applicant’s premises. (xvi) That the supplier shall be at liberty to adjust the electricity consumption charges along with any other charges against the security deposits paid by the Applicant, in the event of termination of agreement or in case of any contractual default. (xvii) To pay any sum which may be found to become payable to Supplier with regards to all liabilities personally as well as by means of both movable properties. And, (xviii) To deposit additional consumption security / ACD as revised by UHBVN from time to time as per the prevailing regulations of HERC. And, (xix) That the supplier shall be at liberty to transfer the dues remaining unpaid by the applicant to other sevice connection (s) that may stand in the Applicants name and recover the same against consumption security / ACD. And, (xx) That the applicant would let supplier to disconnect the service connection under reference, in the event of any default, non- compliance of statutory provisions and in the event of legally binding directive by a authority. (xxi) The applicant is not a defaulter under the jurisdiction of UHBVN and DHBVN, And, 61

(xxii) There is no outstanding defaulting amount against the premises on which the connection is being sought. And, (xxiii) To pay any sum which may be found to become payable to supplier with regards to past dues of supplier of the above premises. And, (xxiv) That the applicant shall abide by the power cut, restricted /peak load hour’s restrictions imposed by the Supplier fromtime to time. And, (xxv) All details furnished in this Application and Agreement forms are true to the Applicant’s knowledge. If any information is found incorrect / concealed at a later stage, the supplier will have the right to withhold/ disconnect supply without any notice, as the case may be and forfeit the securities deposited with the supplier will have right to adjust all dues against the security deposits. And, The Applicant further aggress that this declaration given by him will be construed as an agreement with the (UHBVN) / supplier to the above effect.

Witness Name Father’s name Address

Signature of the Applicant Account Number Signature Name of the Applicant

List of documents to be attached with A&A Form ( if required, Specimen of indemnity bond and available at SDO Office) 5. Copy of registration deed/Municipal or Panchayat House- Tax Assessment Notice/ Allotment letter by HUDA/HSIDC/ Housing Board/ Group Housing Societies/Lease Deed/Receipt of rent paid (Any one of the Document). 6. Consent of landlord or indemnity Bond if consent of landlord not available. In case of tenant seeking connection. 7. for NDS connection, General power of attorney ‘n favor of signatory, in case of joint ownership & partnership firms; Certified true copy of the resolution, authorizing the signatory to deal with the UHBVN, passed by the Board of Directors, in case of companies (as applicable) 8. for NDS connections, self attested photocopy of the partnership deed in case of partnership firms/Memorandum & article of article of association in case of companies (as applicable) 9. Attested copy of any one of documents listed at Sr. No.(8) of page-1 of the form 62

UTTAR HARYANA BIJLI VITRAN NIGAM LTD For office use only Applicant No. :

Applicant Name :

Father’s Name : PAYMENT MADE WITH APPLICATION Accepted on behalf of the Uttar Haryana Bijli Vitran Nigam Ltd. for connected load of KW at voltage level under category connection. Cashier to accept charges on account of the following:- Date Signature ______Sr. No. Item* Amount (in Rs.) 1. Application Processing fee 2. Consumption Security 3. Meter security (if applicable) 4. Meter tedting fee (if applicable) 5. Applicable Service connection Charges 6. Any other item. Total

*Strike out whichever is not applicable. Received Rs (Rupees

Vide Receipt No. Dated

Name Designation Signature 63

CERTIFICATE OF SITE VERIFICATION Certificate that I have personally verified the premises of the applicant at his site on which the supply is required. Name of 11 KV feeder Name of Distribution transformer Name Designation Signature Date______

NO DUES CERTIFICATE Certificate that nothing is due against this applicant or the premises

Name Designation Signature ______Date ______64

AUTHORIZATION FOR CONNECTION For office use only Accepted and Sanctioned on behalf of the Uttar Haryana Bijli Vitran Nigam Ltd. for connected load of KW at voltage level for category connection. Date SDO ‘OP’ The following charges / additional charges, document and equipment for release of connection as per site verification be accepted. (A) Charges:-

(B) Document & Equipments (i) Test report (ii) Energy Meter (if applicable) Date SDO ‘OP’ Received Rs. (Rupees ) Vide Receipt No. Dated: Name Designation Signature

Received Documents & Equipments Name Designation Signature

The Account number allotted to applicant is ______The service connection order number is______Name______Signature______Date______

------DETAILS OF CALCULATION OF LOAD TO BE FILLED BY APPLICANT (Norms may be revised from time to time) S.No. Particulars No. of Total Load For office Points (In KW) use only 1 Light Points (40 watt each) 2 Fan Points (60 watt each) 3 Wall socket (5 Amp) (6 sockets or part there of=40 watts) 4 Wall socket (15 A) (6 sockets or part there f 1KW) 65

5 Rose Outlets for light Point (i) For DS:- 1 to 5 rose outlets (40 watts); 6 to10 rose outlets (2*40 watts) (ii) For NDS:- 40 watt for each rose outlet 6 Air Conditioners through wall socket (take actual load as per capacity) 7 Geysers through wall socket (take actual load as per capacity) 8 Any other motive load in H.P.

Total 66

Acknowledgement

Date Applicant’ Name Category of supply Application Nos.

(Signature of authorized officer)

DECLARATION

Witness Name Father’s name Address

Signature of the Applicant Account Number Signature Name of the Applicant

UTTAR HARYANA BIJLI VITRAN NIGAM LTD For office use only Applicant No. :

Applicant Name :

*Strike out whichever is not applicable. Received Rs (Rupees

Vide Receipt No. Dated

Name Designation Signature 73

NO DUES CERTIFICATE Certificate that nothing is due against this applicant or the premises

Name Designation Signature ______Date ______74

(B) Document & Equipments (i) Test report (ii) Energy Meter (if applicable) Date SDO ‘OP’ Received Rs. (Rupees Vide Receipt No. Dated: Name Designation Signature

Received Documents & Equipments Name Designation Signature

The Account number allotted to applicant is ______The service connection order number is______Name______Signature______Date______

5 Rose Outlets for light Point (i) For DS:- 1 to 5 rose outlets (40 watts); 6 to10 rose outlets (2*40 watts) (ii) For NDS:- 40 watt for each rose outlet

6 Air Conditioners through wall socket (take actual load as per capacity) 7 Geysers through wall socket (take actual load as per capacity) 8 Any other motive load in H.P.

Total 76

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gLrk{kj iVokjh@,e0lh0 80

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4) Loa; rlnhd izek.k i=A

Qhl

ljdkj }kjk fu/kkZfjr%& 15/- :0 izR;sd izek.k i= 84

vuqlwfpr tkfr izek.k i= tkjh djus ckjs izkFkZuk i= ¼dsoy fgUnw /keZ ds fy;s ekU; gksxk½ lsok esa Jheku rglhynkj th ------fo"k;%& vuqlwfpr tkfr izke.k i= tkjh djus ckjs izkFkZuk i=A Jheku th izkFkhZ fuEufyf[kr izkFkukZ djrk gw¡%& eSa ------iq= Jh ------fuoklh ------gw¡A 1. ;g fd eSa izkFkhZ ------tkfr ls laca/k j[krk gw¡A tksfd ljdkj }kjk vuqlwfpr tkfr ?kksf"kr dh xbZ gSA 2. ;g fd izkFkhZ fgUnw /keZ ls lEcU/k j[krk gSA 3. ;g fd eq> izkFkhZ us igys fdlh jkT; ls vuqlwfpr tkfr dk izek.k i= ugha cuok;k gS vkSj u gh bldk dksbZ ykHk mBk;k gSA vr% tukc ls izkFkZuk gS fd eq> izkFkhZ dk vulwfprq tkfr dk izek.k i= tkjh djus dh d`ik djsaA rlnhd fd;k tkrk gS fd izkFkhZ ------iq= Jh ------fuoklh ------dk LFkkbZ@tUe ls fuoklh gS vkSj ;g ------tkfr vkSj ------/keZ ls lEcU/k j[krk gSA

ljiap@uEcjnkj@,e-lh- 85

C;ku gYQh vuqlwfrp tkfr izek.k i= tkjh djus ds fy, eSa ------iq= Jh ------fuoklh ------gw¡ vkSj vius gYQs eas fuEufyf[kr C;ku djrk gw¡ fd %& 1. ;g fd eq> izkFkhZ dk mijksDr uke o irk fcYdqy lgh gSA 2. ;g fd eSa izkFkhZ ------tkfr ls lEcU/k j[krk gw¡ tks fd ljdkj }kjk vuqlwfpr tkfr ?kksf"kr j[krk gSA 3. ;g fd izkFkhZ fgUnw /keZ ls lEcU/k j[krk gSA 4. ;g fd eq> izkFkhZ us igys fdlh jkT; ls vuqlwfpr tkfr dk izek.k i= ugha cuok;k gS vkSj u gh bldk dksbZ ykHk mBk;k gSA 5. ;g fd eq> izkFkhZ }kjk fn;s x;s rF; ;fn xyr ik;s x;s rks ejss fo:) /kkjk vkbZ0ih0lh0 182 ds rgr dk;Zokgh dh tk;sA 6. ;fn izkFkhZ fookfgr gS rks fookfgr L=h dh 'kknh ls igys dh tkfr ekU; gksxhA vr% fookfgrk ------tkfr ls laca/k j[krh gSA

izkFkhZ rlnhd%& rlnhd fd;k tkrk gS fd eq> izkFkhZ dk mijksDr C;ku gYQh esjh tkudkjh ds vuqlkj lgh gSA blesa dqN Hkh fNik;k ;k >qByk;k ugha x;k gSA

izkFkhZ fnukad%& 86

iVokjh@,e0lh0 }kjk vuqlwfpr tkfr izek.k i= tkjh djus ckjs fjiksVZ ¼dsoy fgUnw /keZ ds fy;s ekU; gksxk½ rlnhd fd;k tkrk gS fd izkFkhZ Jh@dqekjh ------iq=@iq=h ------fuoklh ------dk LFkkbZ fuoklh gSA 1. izkFkhZ dk uke jk’ku dkMZ esa ntZ gS ¼dkMZ la[;k ------½ vFkok ughaA 2. izkFkhZ dk oksVj igpku i= ¼oksVj igpku la[;k ------½@ oksVj fyLV eas uke ntZ gS vFkok ughAa 3. izkFkhZ ------tkfr ls lEcU/k j[krk gS ftls Hkkjr ljdkj }kjk vuqlwfpr tkfr ?kksf"kr fd;k gS rFkk 4. izkFkhZ fgUnw /keZ ls lac/ka j[krk gSA 5. ;fn izkFkhZ fookfgr gS rks fookfgr L=h dh 'kknh ls igys dh tkfr ekU; gksxhA vr% fookfgrrk ------tkfr ls laca/k j[krh gSA vr% mijksDr izkFkhZ dk vuqlwfpr tkrh izek.k i= tkjh djus dh flQkfj’k dh tkrh gSA

gLrk{kj iVokjh@,e0lh0 87

fiNM+h Js.kh tkfr dk izek.k i= iz’u1 fiNM+h Js.kh dk izek.k i= D;k gS\ mrj fiNM+h Js.kh dk izek.k i= fdlh O;fDr dk ml fo’ks"k tkfr ls laca/k j[kus dk lcwr gS ftls Hkkjr ds lafo/kku esa fiNM+h Js.kh esa funsZf’kr fd;k x;k gSA iz’u2 fiNM+h Js.kh tkfr dk izek.k i= izkIr djus ds fy, D;k t:jh gS\ mrj 1) fu/kkZfjr QkeZA

2) izkFkhZ dk jk’ku dkMZ@oksVj dkMZ@fdlh ,d uke@oksV lwph esa ukeA

3) iVokjh uxj ifj"kn ds lnL; o ljiap }kjk rlnhd i=A

4) izkFkhZ dh vk; lwpukA

5) izkFkhZ ds ifjokj esa dksbZ jktif=r vf/kdkjh ugha gSA

6) izkFkhZ dh tkfr@/keZ fjiksVZ

7) 'kknh ls igys efgyk }kjk tkfr izek.k i=

8) Loa; rlnhd izek.k i=

Qhl tkfr izek.k i= izkIr djus ds fy, ljdkj }kjk fu/kkZfjr 15 :0 Qhl tek djokuh gksrh gSA 88

ch0lh0 izzez k.k i= tkjh djuss ckjss izzkz FkZuZ k i= B.C./ 001 loks eas Jheku rglhynkj th ------fo"k;%& ch0lh0 izzez k.k i= tkjh djuss ckjss izzkz FkZuZ k i=

Jheku th izkFkhZ fuEufyf[kr izkFkZuk djrk gWwa %& eSa ------iq= Jh ------fuoklh ------gwWa A 1- ;g fd eaS izkFkhZ ------tkfr ls lEcU/k j[krk gWwa tksfd ljdkj }kjk fiNM+h tkfr ?kksf"kr dh xbZ gS A 2- ;g fd e>q izkFkhZ dh lHkh lk/kukas dks feykdj okf"kZd vk; e0q ------@& : gS A 3- ;g fd e>q izkFkhZ dk ifjokj eas ls dksbZ Hkh lnL; jktif=r vf/kdkjh ds in ij ugha gS A 4- ;g fd eq> izkFkhZ dk ifjokj fdzehys;j esa ugha vkrk A 5- ikz FkhZ dk ifjokj dk dksbZ Hkh lnL; vk;dj nkrk gS ;k ugha gS A 6- ;fn ikz FkhZ fookfgr gS rks fookfgr L=h dh 'kknh ls igys dh tkfr ekU; gkxs h vr% fookfgrk ------tkfr ls lEcU/k j[krh gS A 7- ;g fd e>q izkFkhZ us igys fdlh jkT; ls fiNM+h tkfr dk izek.k i= ugha cuok;k gS vkSj u gh bldk dksbZ ykHk mBk;k gS A vr% tukc ls izkFkZuk gS fd e>q izkFkhZ dk fiNM+h tkfr dk izek.k i= tkjh djus dh dik` djsa A

/kU;okn izkFkhZ fnukad %& rlnhd fd;k tkrk gS fd izkFkhZ ------iq= Jh ------fuoklh ------dk LFkkbZ @ tUe ls fuoklh gS vkSj ;g ------tkfr vkSj ------/keZ ls lEcU/k j[krk gS A

ljiap @ uEcjnkj @,e-lh- 38 | P a g e 89

C;ku gYQh B.C./ 002

Ckh- lh- izek.k i= tkjh djus ds fy, eaS ------i=q Jh ------fuoklh ------gwWa vkSj vius gYQs ls fuEufyf[kr C;ku djrk gWwa fd %&

1- ;g fd eq> ikz FkhZ dk mijksDr uke o irk fcYdy lghq gASS 2- ;g fd eaS izkFkhZ ------tkfr ls lEcU/k j[krk gwWa tks fd ljdkj }kjk fiNM+h tkfr ?kksf"kr dh xbZ gS A 3- ;g fd ejks uke jk'ku dkMZ eas ntZ gS ¼jk'ku dkMZ l[a ;k ------½ 4- ;g fd e>q ikz FkhZ dh lHkh lk/kukas dks feykdj okf"kdZ vk; e0q ------@& : gS A 5- ;g fd e>q ikz FkhZ dk ifjokj eas ls dksbZ Hkh lnL; jktif=r vf/kdkjh ds in ij ugha gS A 6- ;g fd eq> izkFkhZ dk ifjokj fdez hys;j esa ugha vkrk A 7- ;g fd izkFkhZ ds ifjokj dk dksbZ Hkh lnL; vk;dj nkrk gS ;k ugha 8- ;fn ikz FkhZ fookfgr gS rks fookfgr L=h dh 'kknh ls igys dh tkfr ekU; gkxs h vr% fookfgrk ------tkfr ls lEcU/k j[krh gS A 9- ;g fd e>q ikz FkhZ us igys fdlh jkT; ls fiNM+h tkfr dk iek.z k i= ugha cuok;k gS vkSj u gh bldk dkbs Z ykHk mBk;k gS A

izkFkhZ rlnhd%&

rlnhd fd;k tkrk gS fd eq> ikz FkhZ dk mijksDr C;ku gYQh ejhs tkudkjh ds vuqlkj lgh gS A blesa dqN Hkh fNik;k ;k >qByk;k ugha x;k gS A

izkFkhZ fnukad%& 90

iVokjh@,e0lh0 ds }kjk ch0lh0 izek.k i= tkjh djus ckjs fjiksVZ rlnhd fd;k tkrk gS fd ikz FkhZ Jh@dekq jh ------i=q @i=q h ------fuoklh ------dk LFkkbZ fuoklh gS A 1- izkFkhZ dk viuk edku o tehu gS vFkok ugh]a ;fn gS rks fdruh------2- ikz FkhZ dk uke jk'ku dkMZ esa ntZ gS ¼dkMZ la[;k ------½ vFkok ugha ;k izkFkhZ dk oksVj igpku i= ¼oksVj igpku la[;k ------½ @oksVj fyLV esa uke ntZ gS vFkok ughaA 3- izkFkhZ ------tkfr ls lEcU/k j[krk gS ftls Hkkjr ljdkj }kjk fiNMh tkfr?kkfs "kr fd;k gAS 4- izkFkhZ dh leLr ifjokj dh lHkh lk/kukas ls okf"kZd vkenuh yxHkx ------@& :Ik;s gS A 5- ikz FkhZ ds ifjokj dk dksbZ Hkh lnL; jktif=r vf/kdkjh ugha gS A 6- izkFkhZ dk ifjokj dhz ehys;j eas ugha vkrk A 7- izkFkhZ dk ifjokj dk dkbsZ Hkh lnL; vk;dj nkrk gS ;k ugha A 8- ;fn ikz FkhZ fookfgr gS rks fookfgr L=h dh 'kknh ls igys dh tkfr ekU; gkxs h vr% fookfgrk ------tkfr ls lEcU/k j[krh gS A vr% mijksDr RkF;kas ds vk/kkj ij ikz FkhZ dks ch0lh0 iez k.k i= tkjh djus dh flQkfj'k dh tkrh gS A

gLrk{kj iVokjh@,e0lh0 91

vfrfjDr fiNM+h Js.kh tkfr dk izek.k i= iz’u1 vfrfjDr fiNM+h Js.kh dk izek.k i= D;k gS\ mrj vfrfjDr fiNM+h Js.kh dk izek.k i= fdlh O;fDr dk ml fo’ks"k tkfr ls laca/k j[kus dk lcwr gS ftls Hkkjr ds lafo/kku esa vfrfjDr fiNM+h Js.kh esa funsZf’kr fd;k x;k gSA iz’u2 vfrfjDr fiNM+h Js.kh tkfr dk izek.k i= izkIr djus ds fy, D;k t:jh gS\ mrj 1) fu/kkZfjr QkeZA

2) jk’ku dkMZ@oksVj dkMZ@fdlh ,d uke@oksV lwph esaA

3) iVokjh uxj ifj"kn ds lnL; o ljiap }kjk rlnhdA

4) vk; lwpukA

5) ifjokj esa dksbZ jktif=r vf/kdkjh ugha gSA

6) tkfr@/keZ fjiksVZ

7) 'kknh ls igys efgyk }kjk tkfr izek.k i=

8) Loa; rlnhd izek.k i=

Qhl tkfr izek.k i= ikIr z dju s ds fy, ljdkj }kjk fu/kkZfjr 15 :0 Qhl tek djokuh gksrh gSA 92

ApplicationformforCertificateofOtherBackwardClasses O.B.C / 001

(This form however should be used as a model additional items, if necessary, may be incorporate to suit to the local situation in the form)

To The Tehsildar Jagadhri (Haryana)

Sir,

I request that a certificate in respect of reservation of other Backward Classes in Civil and services under Govt. of India be granted to me.

I give below the necessary particulars:-

1. Full Name of the Applicant :- (In Block Letters) 2. Date of Birth :- 3. Complete Residential a) Present :-

b) Permanent :- 4. Religion :- 5. Caste :- 6. Sub-Caste :- 7. Occupation :- 8. Serial Number of the caste in Central List of OBC’s :- 9. Name of Father :- 10. Name of Mother :- 11. Name of Husband :- 12. Status of Husband/Parents (s) :-

Father Mother Husband

a) Constitunal Posts b) Designational c) Governmental Services. i) Service (Central/State) ii) Designation iii) Scale of pay including 93

Classification, if any iv) Date of appointment to the post v) Age at the time of promotion to class I post (if Applicable):- II. Employement in International Organisation eg. UN, UNICEF, UNO. i) Name of Organisation :- ii) Designation :- iii) Period of service (indicate date from to i) Death/Incapacitation (Omit if not applicable) Putting officer out of service :- ii) Details of permanent incapacitation. C. Department in Public Sector undertaking etc. i) Name of the Organisation: ii) iv) Date of appointment to the post:- D. Arms forces including Para-Military Forces. (This will not include persons holding civil posts) i) Designation ii) Scale of Pay E. Professional include persons holding civil covered In NOS.S & Sand those engaged in Trade, Business and Industry:- i) Orgn. Profession:- F. Property owners:- I. Agricultural Land Holding Owner by Mother, Father, minor children i) Location :- ii) Size of holding iii) a) Irrigated:- (Type of irrigated Land) (i) (ii) (iii) b) Unirrigated iv) Percentage of irrigated land holding to statutory ceiling limit under state land ceiling laws. v) If any lying is both irrigated/unirrigated total land holding on the state land ceiling Law. vi) Percentage in ceiling limit as per (iv) E)-II- Plantation i) Crops/fruit :- ii) Location iii) Area of plantation 94

F)-III- Vacant land/or building in urban areas Or urban applemention…………………………………. i) Location of property :- ii) Details of property:- iii) Use of which it is put :- G) Income/wealth i) Annual family income from all sources (Excluding salary & income from agricultural land.) ii) Whether Tax Pay (Yes/No) (If yes a copy of the last three years return be furnished). iii) Whether covered in wealth Tax Act. (Yes/No) H) H) Any other remarks 95 C;ku gYQh

vks +ch +lh + tkfr izek.k i= ds fy,s

eSa &&&&&&&&&&&&iq= Jh &&&&&&&&&&&&&&&&& fuoklh &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&gwWa vkSj vius gyQs ls fuEufyf[kr C;ku djrk gwWa%&

1. ;g fd eq> izkFkhZ dk mijksDr uke o irk fcYdqy lgh gSA 2. ;g fd izkFkhZ&&&&&&&&&&&&&&&&tkfr ls lEcU/k j[krk gS tksfd ljdkj }kjk vks0 ch0lh0 tkfr ?kksf"r dh xbZ gSA 3. ;g fd esjk uke jk’ku dkMZ esa ntZ gS {jk’ku dkMZ la[;k&&&&&&&&&&&&&& &&&&&&&&& 4. ;g fd eq> izkFkhZ dh lHkh lk/kukas dks feykdj okf"kdZ vk; eq0 &&&&&&&&&&&&&&&&&&&&& :I;s gS vkSjk esa vk;dj nkrk gwWa @ ugha gwWaA 5. izkFkhZ dk ifjokj dheyss ;j e sa ugha vkrkA 6. eSa vkSj esjs ifjokj esa dksbZ Hkh lnL; jktif=r vf/kdkjh gS ;k ughaA 7. ;g fd izkFkhZ ds ifjokj dk dksbZ Hkh lnL; vk;dj nkrk gS ;k ugha 8. ;fn izkFkhZ fookfgr gS rks fookfgr L=kh dh ’kknh ls igys dh tkfr ekU; gksxh vr% fookfgrk &&&&&&&&&&tkfr ls lEcU/k j[krh gSA

izkFkhZ rlnhd% rlnhd fd;k tkrk gS fd eq> izkFkhZ dk mijksDr C;ku gYQh esjh tkudkjh ds vuqlkj lgh gSA blesa dqN Hkh Nqik;k ;;k >qByk;k ugha x;k gSA

izkFkhZ 96

iVokjh@,e lh0lh0 }kjk tkjh fjiksVZ vks0ch0lh0 izek.k i= tkjh djus ckkjs rlnhd fd;k tkrk gS fd izkFkhZ Jh@ dqekjh++++++++++++++++++++++&&&&&&&&&&&&&&&iq=@iq=h &&&&&&&&&&&&&&&&&&fuoklh&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&& dk LFkkbZ fuoklh gSA 1. izkFkhZ dk viuk edku o tehu gS vFkok ugha ;fn gS rks fdruh &&&&&&&&&&&&&&&&& 2. izkFkhZ dk uke jk’ku dkMZ esa ntZ gS ( dkMZ la[;k &&&&&&&&&& 3. izkFkhZ dk oksVj igpku i= ( oksVj igpku la[;k&&&&&&&&&& 4. izkFkhZ dh leLr ifjokj dh lHkh lk/kuksa ls okf"kZd vkenuh yxHkx&&&&&&&&&&&&&&&&@ :I;s gSA 5. izkFkhZ &&&&&&&&&&&&&&&&tkfr ls lEcU/k j[krk gS ftls Hkkjr ljdkj }kjk vks0ch0lh0 ?kksf"kr fd;k; gSA 6. izkFkhZ dk ifjokj dhehys;j esa ugha vkrkA 7. ;g fd izkFkhZ ds ifjokj dk dksbZ Hkh lnL; vk;dj nkrk gS ;k ugha 8. ;fn izkFkhZ fookfgr gS rks fookfgr L=h dh ’kknh ls igys dh tkfr ekU; gksxh vr% fookfgrk&&&&&&&&&tkfr ls lEcU/k j[krh gSA

gLrk{kj iVokjh@,e0lh0 vr% mijksDr rF;ksa dks /;ku esa j[krs gq,s eSa izkFkhZ dk vks +ch + lh + izek.k i= cuokus dh flQkfj’k djrk gwWaA gLrk{kj iVokjh@,e0lh0 97

Vijhokl o foeqDr tkfr ls lacaf/kr cPpksa ds fy, izek.k i= iz’u1 Vijhokl@foeqDrh tkfr ls lacaf/kr izek.k i= ls D;k vfHkizk; gS\ mrj Vijhokl@foeqDrh tkfr izek.k i= fdlh O;fDr dk ml fo’ks"k tkfr ls lac/ka j[kus dk lcwr gS ftls Hkkjr ds lafo/kku esa Vijhokl@foeqDrh tkfr Js.kh esa funsZf’kr fd;k x;k gSA iz’u2 Vijhokl@foeqDrh tkfr ls lacaf/kr cPpksa dks f’k{kk laLFkkuksa esa nkf[kyk o othQk ysus ds fy, izek.k i= dSls fy;k tkrk gS\ mrj Vijhokl@foeqDrh izek.k i= izkIr djus ds fy, vkosnu rglhynkj ;k mi rglhynkj ds lkeus izLrqr fd;k tk;sxkA iz’u3 Vijhokl@foeqDrh tkfr izek.k i= izkIr djus ds fy, D;k t:jh gS\ mrj 1) fu/kkZfjr izkFkZuk i=A 2) jk’ku dkMZ@oksVj dkMZ@fdlh ,d uke@oksV lwph esaA 3) iVokjh uxj ifj"kn ds lnL; o ljiap }kjk rlnhdA 4) vk; lwpukA 5) viuh okLrfod lwpukA 6) Ldwy dk fu/kkZfjr izek.k i= 7) ru[okg dh lwpuk ;fn ljdkjh deZpkjhA 8) Loa; rlnhd izek.k i= Qhl

Vijhokl@foeqDrh tkfr izek.k i= izkIr djus ds fy, ljdkj }kjk fu/kkZfjr 15 :0 Qhl tek djokuh gksrh gAS 98 Vijhokt@foeqDr tkfr izek.k i= tkjh djus ckjs izkFkZuk i= lsok esa Jheku rglhynkj Tkxk/kjh fo"k;% vk; dk izek.k i=tkjh djus ckjs izkFkukZ i=A Jheku th] eSa izkFkhZ fuEufyf[kr izkFkZuk djrk gwaW fd % eSa &&&&&&&&&&&&&&& iq= Jh &&&&&&&&&&&&& fuoklh &&&&&&&&&&&&&&&&&&& gwaWA 1. ;g fd eq> izkFkhZ dk mijksDr uke irk fcYdqy lgh gSA 2. ;g fd eSa izkFkhZ &&&&&&&&&&&&&&&&&tkfr ls lEcU/k j[krk gwaw tks fd Lkjdkj }kjk Vijhokt@ foeqDr tkfr ?kskf"kr dh xbZ gSA 3. ;g fd izkFkhZ fgUnw /keZ ls lEcU/k j[krk gSA 4. ;g fd eq> izkFkhZ us igys fdlh jkT; ls Vijhokt@ foeqDr tkfr dk izek.k i= ugha cuok;k gS vkSj u gh bldk dksbZ ykHk mBk;k gSA 5. ;fn izkFkhZ fookfgr gS rks fookfgr L=h dh ’kknh ls igys dh tkfr ekU; gksxh vr% fookfgrk &&&&&&&&&tkfr ls lEcU/k j[krh gSA 6. ;g fd eq> izkFkhZ }kjk fn;s x,s rF; ;fn xYr ik;s x;s rks esjs fo:} /kkjk vkbZ0ih0lh0 182 ds rgr d;Zokgh dh tk,sA vr% tukc ls izkFkZuk gS fd eq> izkFkhZ dk Vijhokt@foeqDr tkfr dk izek.k i= tkjh djus dh d`ik djsaA izkFkhZ eq>k izkFkhZ dh mijksDr ?kks"k.kk esjh tkudkjh ds vuqlkj lgh gSA blesa dqN Hkh fNik;k ;k >qByk;k ugha x;k gSA

fnukad&&&&&&&& izkFkhZ ljiap@ uEcjnkj@,e0lh0 dh fjiksVZ rlnhd fd;k tkrk gS fd izkFkhZ &&&&&&&&iq= Jh &&&&&&&fuoklh&&&&&&&&&&dk LFkkbZ@ tUe ls fuoklh gS vkSj ;g &&&&&&&&&tkfr vkSj&&&&&&&/keZ ls lEcU/k j[krk gSA

ljiap@uEcjnkj@,e0lh0 99 iVokjh@,e0 lh0 }kjk Vijhokt foeqDr tkfr izek.k i= tkjh djus ckkjs fjiksVZ rlnhd fd;k tkrk gS fd izkFkhZ Jh@ dqekjh++++++++++++++++++++++&&&&&&&&&&&&&&&iq=@iq=h &&&&&&&&&&&&&&&&&&fuoklh&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&& dk LFkkbZ fuoklh gSA 1. izkFkhZ dk uke jk’ku dkMZ esa ntZ gS ( dkMZ la[;k&&&&&&&&&&& ) 2. izkFkhZ dk oksVj igpku i= ( oksVj igpku la[;k&&&&&&&&&&& ) 3. izkFkhZ&&&&&&&&&&&&&&tkfr ls lEcU/k j[krk gS ftls Hkkjr ljdkj }kjk Vijhokt @ foeqDr tkfr ?kksf"kr fd;k gS rFk 4. izkFkhZ fgUnq /keZ ls lEcU/k j[krk gSA 5. ;fn izkFkhZ fookfgr gS rks fookfgr gS rks fookfgr L=h dh ‘’kknh ls igys dh tkfr ekU; gksxh vr% fookfgrk&&&&&&&&&tkfr ls lEcU/k j[krh gSA

vr% mijksDr izkFkhZ dk vuqlwfpr tkfr izek.k i= tkjh djus dh flQkfj’k dh tjrh gSA

gLrk{kj iVokjh@,e0lh0 100

vk;q izek.k i= iz’u1 vk;q izek.k i= ls D;k vfHkizk; gS\ mrj og izek.k i= tks fdlh O;fDr dh vk;q n’kkZrk gS mls vk;q iek.k dgrzs gSaA iz’u2 vk;q izek.k i= ds fy, D;k nLrkost vko’;d gSa\ mrj 1) fu/kkZfjr QkeZ

2) ftl O;fDr ds fy, vk;q izek.k i= dh vko’;drk gS mldk tUe dk izek.k t:jh gSA

3) tUe dk LFkku] fnukad vkSj le; dk 'kiFk i=A

4) jk’ku dkMZ@Ldwy NkMs+us dk lVhZfQdsV ftlesa tUe frfFk fyf[k gks] lHkh nLrkost jktif=r vf/kdkjh }kjk lR;kfir fd;s gksaA iz’u3 vk;q izek.k i= ysus ds fy, D;k Qhl gS\ mrj vk;q izek.k i= fu’k%ydq feyrk gS ;fn MqifydsV izek.k i= ysuk gS rks blds fy, 5/- :0 'kqYd fy;k tk;sxkA iz’u3 vk;q izek.k i= dgka ls feyrk gS\ mrj vk;q izek.k i= lacaf/kr jftLVªkj tUe o e`R;q dk;kZy; ls izkIr fd;k tk ldrk gSA 101

The District Registrar, Births and Deaths, District .

Subject: - Request for Birth Certificate.

Sir, Kindly issue me copies of birth certificate as per particulars are give below:

1. Date of Birth 2. Name of Child 3. Sex 4. Plac(M le o /Ff Birth l ) 5. Name of Father 6. Name of Mother 7. Permanent Address 8. Birth order

Thanking you, Yours faithfully,

( ) Name ______Address ______Total amount of Rs.______Dated ______Receipt No.______102

vk; izek.k i= iz’u1 vk; izek.k i= ls D;k vfHkizk; gS\ mrj og i= tks fdlh O;fDr dh okf"kZd vk; n’kkZrk gks mls vk; iek.kz i= dgk tkrk gSA iz’u2 vk; izek.k i= dh dgka ij vko’;drk gksrh gSa\ mrj vk; izek.k i= dh f’kf{k.k laLFkkuksa eas nkf[kyk ysus ds fy, o Nk=kokl esa nkf[kyk ysus ds fy, rFkk oftQk ysus ds fy, vko’;drk gksrh gSA iz’u3 vk; izek.k i= cuokus ds fy, fdu nLrkostksa dh t:jr gksrh gS\ mrj 1) fu/kkZfjr QkeZA 2) jk’ku dkMZ@oksVj dkMZ ;k oksVj lwph esa uke buesa ls dksbZ ,dA 3) Loa; ?kksf"kr izek.k i=A 4) Ldwy izek.k i=A 5) ;fn dksbZ jktfd; deZpkjh gS rks ml n’kk esa osru fLyiA iz’u4 vk; izek.k i= cuokus dh D;k izfØ;k gS\ mrj xzkeh.k Lrj ij%& xzkeh.k Lrj ij okf"kZd vk; izek.k i= ds fy, ljdkj }kjk fu/kkZfjr QkeZ ij lacaf/kr iVokjh viuh fjiksVZ djrk gSA iVokjh dh fjiksVZ dks dkuwuxks rlnhd djrk gS vkSj lacaf/kr rglhynkj }kjk ;ksX; crk;s tkus ftlds mijkUr mi&e.My vf/kdkjh ¼ukxfjd½ vk; izek.k i= tkjh djrk gSA 'kgjh Lrj ij%& 'kgjh Lrj ij okf"kZd vk; izek.k i= ds fy, ljdkj }kjk fu/kkZfjr QkeZ ij lacaf/kr uxj ikfydk@uxj ifj"kn dk lfpo@dk;Zdkjh vf/kdkjh rlnhd djrk gS vkSj blds mijkUr mi&e.My vf/kdkjh ¼ukxfjd½ vk; izek.k i= tkjh djrk gSA iz'u5 vk; izek.k i= ysus ds fy, Qhl D;k gS\ mrj vk; izek.k i= ysus ds fy, fu/kkZfjr Qhl 15 :i;s gSA 103 vk; dk izek.k i= tkjh djus ckjs izkFkZuk i= dsoy f’k{kk dk;ksZa ds iz;ksx gsrq lsok esa Jheku rglhynkj Tkxk/kjh fo"k;% vk; dk izek.k i=tkjh djus ckjs izkFkZuk i=A

Jheku th] eSa izkFkhZ fuEufyf[kr izkFkZuk djrk gwaW fd % 1. esa&&&&&&&& iq=Jh &&&&&&&&&fuoklh&&&&&&&&&gwWAa 2. ;g fd eq> izkFkhZ dh lHkh lk/kuksa dks feykdj okf"kZd vk; eq0&&&&&&/ :Ik;s gS vkSj esa vk;dj nkrk gwWa / ugha gWawA 3. ;g fd eq> izkFkhZ dks vius gdhdh yM+ds/yM+dh&&&&&&&&&&& ds ’kS{kf.kd dk;ksZ ds fy;s vk; izek,k i= dh vko’;drk gSA vr% tukc ls izkFkZuk gS fd eq> izkFkhZ dk vk; izek.k i= tkjh djus dh d`ik djsaA /kU;okn fnukad&&&&&& 104 Loa; lR;kfir ?kks"k.kk i= eSa&&&&&&&&&iq= Jh&&&&&&&&fuoklh&&&&&&&&&gwWa vkSj vius gYQs ls fuEufyf[kr C;ku djrk gwWa vFkok djrh gwWa fd% 1. ;g fd eq>k ’kiFkdrkZ dk mijksDr uke o irk fcYdqy lgh gSA 2. ;g fd esjk uke jk’ku dkMZ esa ntZ gS jk’ku dkMZ la[;k&&&&&&&&&&& 3. ;g fd eq> izkFkhZ dh lHkh lk/kuksa dks feykdj okf"kd vk; eq0 &&&&&&/ :Ik;s gS vkSj eSa vk;dj nkrk gwWa / ugha gwWaA 4. ;g fd eq> izkFkhZ dks vius gdhdh yM+ds/yM+dh&&&&&&ds ’kS{kf.kd dk;ksZa ds fy;s vk; izek.k i= dh vko;;drk gSA 5. ;g izkFkhZ fookfgr/ vfookfgr gSA

’kiFkdrkZ

rlnhd % Rklnhd fd;k tkrk gS fd eq> ’kiFkdrkZ dk mijksDr C;ku gYQh esjh tkudkjh ds vuqlkj lgh gSA blesa dqN Hkh fNik;k ;k >qByk;k x;k gSA

’kiFkdrkZ

fnukad%&&&&&&&& 105 vk; dk izek.k i= tkjh djus ckjs rlnhd fd;k tkrk gS fd izkFkhZ Jh / dqekjh &&&&&&&&&& iq=@iq=h&&&&&&&&&&fuoklh&&&&&&&&&&&&dk LFkbZ fuoklh gSA

1. izkFkhZ dk viuk edku o tehu gS vFkok ugha] ;fn gS rks fdruh&&&&&&& 2. izkFkhZ dk uke jk’ku dkMZ esa ntZ gS ;k ugha gS rks dkMZ la[;k&&&&&&&&&& 3. izkFkhZ dk oksVj igpku la[;k &&&&&&&& oksVj fyLV esa uke ntZ gS vFkok ughaA 4. izkFkhZ dh leLr ifjokj ds lHkh lk/kuksa ls okf"kZd vkenuhyxHkx&&&&&&&&&&:Ik;s gSA 5. ;g izkFkhZ fookfgr @ vfookfgr gSA

gLrk{kj iVokjh@,e0lh0 106

ukxfjd vf/kdkj i=

ç’u1 gfj;k.kk esa pquko foHkkx ds dk;kZy; dgka LFkkfir gS\ mrj ftyk Lrj ij ;g dk;kZy; ftyk pquko dk;kZy; ds uke ls mik;qDr ¼fMIVh dehf’ku½ ds vUrxZr dk;Z djrk gS] ftldk pquko rglhynkj@mi rglhynkj dkedkt laHkkyrs gSa o mi ftyk pquko vf/kdkjh Hkh bl dk;Z ds fy, fu;q g SADr ç’u2 pquko foHkkx ds D;k dk;Z gSa\ mrj ernkrk lwfp;ksa dh rS;kjh o iquuh{k.k djuk] ernkrkvksa ds igpku&i= cukuk] yksdlHkk] fo/kkulHkk] jkT;lHkk] jk"Vªifr] mijk"Vªifr ds pquko lEiUu djokus ls lEcfU/kr dk;kZsa dk lapkyuA pquko foHkkx gfj;k.kk viuk dk;Z Hkkjr fuokZpu vk;ksx ds v/kh{k.k] funsZ’ku o fu;a=.k esa jgdj djrk gSA ç’u3 ernkrk lwph esa uke ntZ djokus ds fy, dkSu ik= gS\ mrj gfj;k.kk dh ernkrk lwph esa viuk uke fy[kokus dk vkidk vf/kdkj gS ;fn vki%& 1) Hkkjr ds ukxfjd gSaA 2) ml pquko {ks= dh ernkrk lwph esa ernkrk ds :i esa viuk uke ntZ djokus ds ik= gS ftlesa vki lkekU;r% jgrs gSA 3) vkosnu dh frfFk ij 18 o"kZ ;k vf/kd ds gS ¼lkekU;r% gj o"kZ dh igyh tuojh dks½] vkSj 4) bl gsrq v;ksX; ?kksf"kr ugha fd, x, gSA ç’u4 ernkrk lwph esa uke tksM+uk gVkuk rFkk la’kks/ku dh D;k izfØ;k gS\ mrj dksbZ Hkh O;fDr tks mijksDr 'krksZa dks iwjk djrk gks] ijUrq mldk uke ernkrk lwph esa ugha gks] viuk uke ernkrk lwph esa tksM+us ds fy, vius fo/kkulHkk fuokZpu {k=s ds ernkrk iathdj.k vf/kdkjh ls lEidZ dj ldrk gSA ernkrk lwph ls uke gVokus ;k Bhd djokus gsrq O;fDr Hkkjr fuokZpu vk;ksx }kjk tkjh lwfp;ksa ds la’kks/ku gsrq fu/kkZfjr vof/k ds nkSjku viuk vkonsu fu/kkZfjr izkfIr LFky ij izLrqr dj ldrk gSaA 107

ç’u5 ernkrk lwph ns[kus ds fy, Qhl fu/kkZfjr Qhl D;k gS\ mrj ernkrk lwph n[kuss ds fy, fuUufyf[kr U;k;ky; 'kqYd fu/kkZfjr Qke Z ij yxkus ds ckn gh iathdj.k vf/kdkjh Lohd`rh iznku djsxk%& Qhl (1) ernkrk lwph dks ns[kus ds fy, Qhl = 12/- (2) orZeku lwph esa fdlh izfof"V dh izekf.kr izfr ysus ds fy, = 12/- Qhl (3) rRdky Qhl = 24/- rRdky Qhl ;fn vkosnd izek.k i= rqjUr pkgrk gks rks lkekU; Qhl dk nksxquk Qhl fy;k tk,xkA 108

FORM 6 [See rules 13(1) and 26 of Registration of Electors Rules, 1960]

APPLICATION FOR INCLUSION OF NAME IN ELECTORAL ROLL To The Electoral Registration Officer, ………………. Assembly/Parliamentary Constituency

Sir,

I request that my name be included in the electoral roll for the above constituency Particulars in support of my claim for inclusion in the electoral roll are given below.

Applicant’s details Name Surname (if any)

Age as on 1st January Years Months Sex (Male/female/others ………….. # Date of birth, if known: Day Month year

Place of birth Village/Town: District State: Father’s Name Name Surname (if any) /Mother’s /Husband’s II. Particulars of place of present ordinary Residence (Full address) House/Door number: Street/Area/Locality/Mohalla/Road: Town/Village: Post Office: Pin Code Tehsil/Taluka/Mandal/Thana: District: III. Details of member(s) of applicant’s family already included in the current electoral roll of the Constituency Name Relationship Part number of Serial number Elector’s Photo with applicant the roll of the in that Part Identify Card Constituency Number 1. 2.

 In case of Union Territories having no Legislative Assembly and the State of Jammu and Kashmir.

 Please give the year i.e. 2007, 2008 etc. 109

 *Strike out the inappropriate alternative.

IV. Declaration:

I hereby declare that to the best of my knowledge and belief:

(i) I am a citizen of India;

(ii) I am ordinarily resident at the address given in para II above since ……….. (date, month, year).

(iii) I have not applied for the inclusion of my name in the electoral roll lfor any other constituency.

(iv) *My name has not already been included in the electoral roll for this or any other assembly constituency.

*My name may have been included in the electoral roll for ……………… Constituency in …………………………….. State in which I was ordinarily resident earlier at the address mentioned below and, if so. I request that the same may be deleted from that electoral roll.

Full dress (earlier place of ordinary Electors photo identity cared number (if residence already issued)

……………………………………. …………………………………….

……………………………………. Date of Issue……………………...

Place:…………… Date………………. Mobile No.

E-mail I.D. Signature or thumb impression of the applicant

Note – Any person who makes a statement or declaration which he either knows or believes to be false or does not believe to be true, is punishable under section 31 of the Representation of the People Act, 1950 (43 of 1950).

*Strike out the inappropriate alternative.

(To be filled by Electoral Registration Officer of the constituency)

The application of

Sh./Smt./Km……………………………….. for inclusion of name in the electoral 110 roll in Form 6 has been

*Accepted

*Rejected

For * acceptance

Detailed reasons for *acceptance

Under or in pursuance of

[Rule 18*/

[Rule 20*]

[Rule 26(4)]

*Rejection (Under or in pursuance of

Rule 17/

Rule 20*/

Rule 26(4)]

Place:

Date Signature of Electoral (Seal of the Electoral Registration Officer Registration Officer)

During continuous updating after final publication of electoral roll.

*Strike out the inappropriate alternative.

------

Remarks of Field Level Officer (e.g. BLO, Designated Officer, Supervisory Officer)

------

Receipt for application 111

(Received the application in Form 6 of **Shri/Smt./Kumari…………………………..

**Address ………………………………………………………………………………

Date……………………. Signature of the officer receiving the application on behalf of the Electoral Registration Officer

Address………………………………………..

……………………………………………….. Toll Free Number :- 1950

Website of Election Commission of India : - www.ecl.nic.in

Website of Chief Electoral officer, Haryana :- www.ceoharyana.nic.in e-mail ID : [email protected]

Note:- For any Inquiry Regarding Electoral Registration Contact the Booth Level Officer (B.L.O)

Name: Tel. No. P.S.No. 112

(This page should be thick enough so that it does not get mutilated/damaged in postal transit)

Intimation of action taken

(Section-II of the page is to be filled by Electoral Registration Officer of the constituency and to be posted to the applicant on the address as given by the applicant in Section-I)

Section – I The application in Form 6 of

Shri/Smt ……………………………….

(Full Address) ……………………………….

House/Door Number ……………………………….

Street/Area/Locality/Mohalla/Road: ……………………………….

Town/village: ……………………………….

Post Office: ……………………………….

Tehsil/Taluka/Mandal/Thana: ……………………………….

District: ……………………………….

**To be filled in by the applicant: ………………………………. Section – II

(a) Accepted and the name of Shri/Smt/Kumari ……………… has been registered at Sr.No………………………. in Part No……………………. of AC No.. ……………………………

(b) Rejected for the reason …………………..

Date:…………….. Electoral Registration Officer (Address) 113

Guidelines for filling up the Application Form – 6 General Instruction

Who can file Form-6

1. First time applicant on attaining age of 18 years or more on the first day of January of the year with reference to which the electoral roll is being revised.

2. Persons shifting his/her place of ordinary residence outside the constituency in which he/she is already registered

When Form 6 can be filed.

1. The application can be filed after draft publication of electoral roll of the constituency. The application is t be filed within the specific days provided for the purpose. Due publicity is given about the above period when the revision programme is announced.

2. Only one copy of the application is to be filled.

3. Application for inclusion of name can be filed through out the year even when the revision programme is not going on. During non-revision period, application must be filed in duplicate.

Where to file Form-6

1. During revision period, the application can be filed at the designated locations where the draft electoral roll is displayed (mostly polling station locations) as well as the Electoral Registration Officer and Assistant Electoral registration Officer of the constituency.

2. During other period of the year when revision programme is not going on, the application can be filed only with the Electoral Registration Officer.

How to Fill the Form-6

The application should be addressed to the electoral Registration Officer of the constituency in which you seek registration. The name of the constituency should be mentioned in the blank space.

Name (With Documentary Proof)

The name as it should appear in the electoral roll and Electors Photo Identity Card (EPIC) should be furnished. The full name except the surname should be written in the first box and surname should be written in the second box. In case you do not have a surname, just write the given name. Caste should not be mentioned except where the 114 caste name is used as part of the elector’s name or a surname. Honorific appellations like Shri, Smt., Kumari, Khan, Begum, Pandit etc. should not be mentioned.

Age (With Documentary Proof)

The age of the applicant should be eighteen or more on 1st January of the year with reference to which the electoral roll is being revised. The age should be indicated in years and months. e.g. A person born on or upto 1/1/1993 will be eligible for inclusion in the electoral roll which is being revised with reference to 1/1/2011. Persons born on 2/1/1993 or thereafter upto 1/1/1994 shall be eligible for inclusion during the next revision with reference to 1/1/2012.

Write your sex in full in the space provided e.g. Male/Female/Others. Applicants may indicate their sex as “Other” where they do not want to be described as male or female.

Date of Birth (With Documentary Proof)

Fill up the date or birth in figures in the space provided in dd/mm/yyyy. Proof of date of birth to be attached are as under.

(a) Birth certificate issued by a municipal Authorities or district office of the Registrar of Births & Deaths or Baptism certificate; or

(b) Birth certificate from the school (Govt./Recognized) last attended by the applicant or any other recognized educational institution; or

(c) If a person is class 10 or more pass, he should give a copy of the mark sheet of class 10, if contains date of birth as a proof of date of birth; or

(d) Mark sheet of class 8 if it contains date of birth; or

(e) Marksheet of class 5 if it Contains date of birth or

(f) A declaration in prescribed format given in Annexure-1 made by either of his parents if the person is not educated till class 10 (in those cases where parental declaration is given as proof age. the applicant will have to be present himself for verification before BLO/ERO/AERO),or

(g) A certifcate of his age given by a sarpanch of the concerned Gram Panchyat or by a member of the concerned Municipal Corporation/Municipal Committee, the person is not educated till class 10 and both the parents are not alive.

(h) Indian Passport 115

Note : Documentary proof of age will be required only in those cases , where age if the applicant is between 18 and 21years. In all other cases declaration of his age by the applicant will be taken as proof of age

6. Place of birth

In case born in India, Please mention name of place like village/Town, District, State.

7. Relation`s Name

In case of unmarried female , applicant, name of Father/Mother is to be mentioned .

In case of married female applicant, name of Husband is to be mentioned . Strike out the inapplicable options in the column.

8. Place of Ordinary Residence.

Fill up the full and complete postal address including PIN code where you are ordinarily residing and want to get registered, In the space provided.

Proof of ordinary residence to be attached are as under:

(i) Bank/Kisan/Post Office current Pass Book, or (ii) Applicants Ration Card/Passport/Driving License/Income Tax Return Filed or Order, or (iii) Latest Water/Telephone/Electricity/Gas Connection Bill for that address, either in the name of the applicant or that of his/her immediate relation like parents etc, or (iv) Postal department`s posts received/delivered in the applicant`s name at the given address.

Note : In case of homeless persons, the BLO will visit the address given in Form6 at night to ascertain that the homeless person actually sleeps at the place which is given as his address in form6,if the BLO is able to verify that the homeless person actually sleeps at the place, no documentary proof of place of residence shall be necessary. BLO must visit for more than one night for such verification.

9. Details of family Members Already Included in the Electoral Roll, Please fill up name and other particulars of immediate family members i.e. Father/mother/Brother/Sister/Spouse included in the current electoral roll of the constituency. Name of any other relation like uncle . aunt ,cousin brother/Sister etc not to be mentioned.

10. Declaration 116

Please indicate dare from which you are residing in the given address. In case the exact date is not known fill-up month and year.

If your name is already included in the electoral roll of any other constituency , please write legibly the full previous address with Pin code.

If you already have been issued with a Photo Identity Card by the Election Commission, Please mention the card number ( printed on the front side) and date of issue (printed on the back side) of the card in the space provided . Please attach a self-attested photocopy of both sides of the card.

Miscellaneous

In many places the photograph of the elector is also printed in the electoral roll. You have the option to submit one recent colored passport –size photograph alongwith the form The photograph will be used to print your image in the electoral roll and issue of identity card, If required.

Please also give your full name and address on the acknowledgement and intimation portions.

Please give your mobile number and e-mail I.D. in the form, which is optional, as the same, if given may be used by the Electoral Registration officer for further communication with the applicant whenever required. 117

tehu D;k gS@tk;nkn dk cSukek D;ksa t:jh gS iz’u1 tehu@tk;nkn dk cSukek ls D;k vfHkizk; gS\ mrj tk;nkn@tehu dk cSukek ls vfHkizk; g S & og nLrkost ftl }kjk vpy lEifr dk ekfydkuk gd izkIr djuk gSA iz’u3 Hkwfe dk iathdj.k dSls izkIr gksrk gS\ mrj Hkwfe dk iathdj.k LFkkuh; iathdj.k vf/kdkjh jktLo dk;Zy; ¼rglhy@mi&rglhy½ ds ek/;e ls izkIr fd;k tkrk gSA iz’u4 Hkwfe ds iathdj.k ds fy, fdu nLrkostksa dh t:jr gksrh gS\ mrj 1) ekydu lcwr QnZ] tekcUnh@iqjkuh iathdj.k@bardky 2) rlnhd ds fy, nksuks i{kksa dk oksV igpku i=@jk’ku dkMZ@ykbZlsal 3) eqf[r;kjukek tgka ij eqf[r;kjukek cuk;k x;k gS mldh rlnhd iz’u2 Hkwfe dk cSukek dgka ij gksrk gS\ mrj Hkwfe dk cSukek lEcaf/kr rglhy dk;kZy; esa djok;k tkrk gSA iz’u3 Hkwfe dk cSukek dkSu fy[k ldrk gS\ mrj Hkwfe dk cSukek ljdkj }kjk fu;qDr nLrkost ys[kd ;k odhy }kjk fy[kk tk ldrk gSA iz’u4 cSukek dh D;k izfØ;k gS\ mrj cSukek djokus ds fy, LVkEi isij [kjhnus ds fy, jkT; ljdkj ds [ktkuk dk;Zy; esa LVkEi isij dh dher tek djok dj isij fudyok;s tkrs gSa mu isijksa ij cSukek fy[kk tkrk gSA ftl ij nksuk s i{k] xokg o nLrkost ys[kd ;k odhy vius gLrk{kkj djrs gSa mlds ckn nLrkost lacaf/kr rglhynkj ds lEeq[k is’k fd;s tkrs gSa vkSj fu/kkZfjr jftLVªs’ku Qhl dh jlhn dVrh gSA rnksijkUr lacaf/kr rglhynkj nLrkost dh jftLVªh djrk gAS 118 iz’u5 bUrdky D;k gS\ mrj tehu esa fdlh Hkh eyfd;r dks cnyko djus ds fy, tks nLrkost eky vf/kdkjh ¼jsoU;w vkQWlj½ }kjk rlnhd fd;k tkrk gS mls bUrdky dgrs gSA iz’u6 bardky ds cnyko ds D;k dkj.k gks ldrs gS\ mrj 1) isr`d & ekfyd dh e`R;q ds dkj.k 2) ifjokfjd foHkktu ls 3) jgu@cSad yksu ds nkf;Roksa ls cSadks }kjk fjyht djus ij vkSj cSad _.k okilh ij 4) vnkyr ds vkns’k ij vnkyr fMØh 5) tu mi;ksx ds fy, ljdkj }kjk vf/kxzg.k 6) xjhc yksxkas dks ljdkj }kjk tehu iznku djuk iz’u7 Hkwfe dk bardky dSls gksrk gS\ mrj Hkwfe dk bardky lacaf/kr rglhy esa iwjs nLrkostksa ds lkFk tSls fd iathd`r cSukek@vnkyr ds vkns’k dh dkih ;k vU; dksbZ nLrkostksa lfgr lacaf/kr iVokjh ds ikl ntZ djok;sxkA ftldh jlhn vkosnd dks nh tk;sxh fd dkuwuxks rglhynkj ls mDr frfFk dks eatwj djok;sxk vkSj mldh rhu dksfi;ka rlnhd djok;sxk ftlesa ,d dksih lacaf/kr iVokjh vius fjdkMZ esa j[ksxk] nwljh dkih iVokjh ds lacaf/kr eky[kkus esa okfil tk;sxh vk Sj rhljh dkih dEiq;Vj vkijsVj ds fjdkMZ esa gksxhA iz’u8 eatwj 'kqnk Hkwfe ds bardky dh Qhl D;k gS\ mrj eatwj 'kqnk Hkwfe ds izR;sd bardky dh Qhl 100 :0 gSA 119

SALE DEED

This deed of sale is executed on day of month of year by

# Name Father’s Name Address Proxy Name Proxy type hereinafter called the "SELLER".

In favour of # Name Father’s Name Address Proxy Name Proxy Type

hereinafter called the "PURCHASER".

Whereas, the term SELLER and PURCHASER, unless repugnant to the context shall mean and include there representatives heirs, successors, executors,administrators, trustees, legal representatives and assigns.

Whereas, the SELLER herein, is the sole and absolute owner of immovable property with following details # PropertyType Khewat Khatoni No. Khasra No./Property No. Area No.

Structure Details # Covered area in sq ft Class of Construction

and morefully described in the schedule hereunder written and hereinafter called the schedule property.

Whereas, the SELLER is the absolute owner, having acquired the property, by and since then SELLER has been in possession and enjoyment of the schedule property and paying taxes and levies thereon, as sole and absolute owner thereof.

Whereas the SELLER herein being desirous of selling the Schedule property due to the reason .

Whereas the PURCHASER has agreed to purchase the schedule property in terms an oral / written agreement for a total sale consideration of Rs. (Rupees only) and the purchaser in terms of aforesaid oral / written agreement agreed to pay the entire sale consideration at the time of execution of the sale deed.

Whereas in consideration of the purchaser having paid the entire sale consideration Rs. (Rupees only) as aforesaid the receipt of which has been duly acknowledged by the 120

SELLER,who acquits the purchaser from making any further payment towards sale consideration, the SELLER, as beneficial owner, DOES HEREBY GRANT, CONVEY, TRANSFER, BY WAY SALE AND ASSIGN unto and in favour of the purchaser of the schedule property and every part thereof together with the right, title and interest therein, with all the benefits advantages, concessions,licenses, hereditaments, easementary rights, equities, claims, demands, privileges,appurtenances or any other things hidden in the earth belonging to or appurtenant thereto etc., attached to belonging to and reputed to belong to the Schedule property TO HOLD, TO POSSESS AND TO ENJOY the same forever free from all encumbrances, charges, all kinds of mortgage, agreement to sell, court litigation's and any other statutory charges.

Whereas the SELLER hereby declares and covenants with the purchaser that he is the sole and absolute owner of the Schedule property and has a clear, legally valid and marketable title thereto and therefore, an absolute right to sell and convey the same to the purchaser in terms of this deed. The SELLER further declares that he has not done any acts, deeds or things so as to curtail, restrict or prejudice his right to convey or prevent him from selling the Schedule property in terms of this deed.Whereas the PURCHASER having now paid the entire sale consideration as detailed below, has requested the SELLER to execute the Sale deed in his favour and the SELLER has duly agreed thereto.

NOW THEREFORE THIS DEED OF ABSOLUTE SALE WITNESSETH AS HEREUNDER: 1. The SELLER hereby confirms that the PURCHASER has paid the entire sale consideration as under: a). Amount paid by Cheque No. or in Cash on dated Rs. b). Remaining amount paid by Cheque or D.D. or Pay order before Sub-Registrar at the time of Registration of this Sale deed Rs. Total Rs. (Rupees only).

Whereas the SELLER hereby further declares that the schedule property is free from all encumbrances, lien, charge, mortgage, lease, court or other attachments,lis-pendens, acquisition and requisition proceedings, minor's claims or any other adverse proceedings or claims from third parties which are in any way detrimental to the interest of the PURCHASER.

Whereas the SELLER hereby assures the PURCHASER that all taxes and levies on the Schedule property have been paid up to date and arrears if any, till the date of sale deed shall be duly paid by him and future taxes in respect of the Schedule property shall be paid by the PURCHASER.

Whereas the SELLER hereby declares and covenants with the PURCHASER that he shall do or cause to be done all acts, deeds and things which are legally or reasonably required to be done at the instance of the PURCHASER for morefully and perfectly assuring the right, title and interest of the PURCHASER in the schedule property herein conveyed and the PURCHASER shall bear such expenses.

Whereas the SELLER hereby indemnifies and keeps the PURCHASER or his successors-in- title fully indemnified against any loss or liability cost or claims,action or proceedings, if any should arise, at any time in future against him owing to any defect in or for want of clear and marketable title or due to any defect,violation or non-compliance of any of the declarations or covenants herein. Whereas the PURCHASER shall be the sole and absolute owner of the schedule property with attendant rights of ownership, possession, enjoyment and shall be entitled to deal with and dispose of the Schedule property as deems fit without any interference, obstruction or hindrance from the SELLER or any one claiming under, through or in trust for him. 121

Whereas the SELLER has this day delivered the vacant possession of the schedule property to the PURCHASER along with all the available original title deeds and documents which are in his possession pertaining to or relating to the schedule property.

SCHEDULE OF THE PROPERTY (Conveyed under this deed)

# PropertyType Khewat No. Khatoni No. Khasra No./Property No. Area

Structure Details # Covered area in sq ft Class of Construction

Bounded by:- On the East : On the West : On the South : On the North : Market value of the property conveyed under this deed is Rs. (Rupees only). The Stamp duty is paid on the market value as computed above. IN WITNESS WHEREOF the parties herein have affixed their respective signatures to this deed at on this day of year in presence of the witness:

WITNESSES:

Name Address Signature Witness of Seller Witness of Buyer

[1 If the seller is represented by his agent such as guardian or general power of attorney holder or special power of attorney holder, then his full name, occupation, age, address and capacity under which he represents the SELLER shall be entered]

[2 if the purchaser is represented by his agent such as guardian or general power of attorney holder or special power of attorney holder, then his full name, occupation, age, address and capacity under which he represents the purchaser shall be entered]

[3Full details of the property number such as Khata number, street/road with reference to the local authority records and boundaries shall be furnished. If the land sold is an agricultural land, details of the survey number, acre, guntas, revenue assessment and boundaries of the land sold with reference to the revenue records should be furnished. If the property purchased is a Flat/Apartment details of the property on which the Flat / Apartment is constructed, flat number, floor number, name of the apartment etc., full details of the property so as to identify shall be furnished.]

[4.Describe whether the ownership is acquired by inheritance or by partition of joint family property or by 122

release or by gift or by settlement or by will (bequeath) or by sale deed executed by registered as document No. of Book No. , Volume No. , Page No. in the office of the Registrar or Sub- Registrar]

[5.To clear of the debt / for higher education of children / to defray medical expenses/domestic necessities]

[6.Full details of the property number such as Khata number, street/road with reference to the local authority records and boundaries shall be furnished. If the land sold is an agricultural land,details of the survey number, acre, guntas, revenue assessment and boundaries of the land soldwith reference to the revenue records should be furnished. If the property purchased is a Flat /Apartment details of the property on which the Flat / Apartment is constructed, flat number, floor number, name of the apartment etc., full details of the property so as to identify shall be furnished.] 123

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fl[kkbZ MªkbZfoax ykblSal iz’u1 fl[kkbZ MªkbZfoax ykblSal dkSu ys ldrk gS\ mrj ftlus 18 lky dh vk;q iwjh dj yh gS og 50cc ds fcuk fx;j ds okgu ds fy, fl[kkbZ MªkbZfoax ykblSal ys ldrk gS vkSj ftlus 16 lky dh vk;q iwjh dj yh gS og Hkh mDr okgu ds fy, fl[kkbZ MªkbZfoax ykblSal ys ldrk gS ysfdu bldh vuqefr ekrk&firk ;k vfHkokgd dks iznku djuh gksxhA iz’u2 fl[kkbZ MªkbZfoax ykblSal fdruh vof/k ds fy, curk gS\ mrj fl[kkbZ MªkbZfoax ykblSal 6 eghus dh vof/k ds fy, curk gSA iz’u3 fl[kkbZ MªkbZfoax ykblSal cuokus ds fy, D;k&D;k nLrkost yxrs gSa\ mrj 1. QkeZ uEcj 1 ¼esfMdy izek.k i=½ vkSj [kqu dk xzqiA 2. QkeZ uEcj 2 ¼fl[kkbZ MªkbZfoax ykblSal dh vuqefr ds fy,½ izkFkhZ dh QksVks o gLrk{kjA 3. fuokl izek.k i= ¼oksV dkMZ@ikliksV@VsZ yhQk su@fctyh fcy vkSj jk’ku dkMZ oxSjk½ 4. vk;q izek.k i=A 5. Loa; ?kksf"kr lVhZfQdsVA 6. nks Nk;%izfr 7. fu/kkZfjr Qhl Qhl ykblSal dh Js.kh LoLF; Qhl lsok ykblSal Qhl VksVy Qhl LdwVj@eksVj lkbZdy 150/- 50/- 30/- 230/- LdwVj@eksVj 150/- 50/- 60/- 260/- lkbZdy@dkj LdwVj@eksVj 150/- 50/- 90/- 290/- lkbZdy@dkj@VjsDVj iz’u4 fl[kkbZ MªkbZfoax ykblSal ysus dh izfØ;k D;k gS\ mrj fl[kkbZ MªkbZfoax ykblSal ljdkj }kjk fu/kkZfjr QkeZ Hkjdj eksVj okgu bLiZSDVj dh lLarqfr ij mi&e.My vf/kdkjh ¼ukxfjd½ }kjk cuk;k tkrk gSA 127

LFkkbZ MªkbZfoax ykblSal iz’u1 LFkkbZ ykblSal cuokus dh D;k 'krsZa gS\ mrj LFkkbZ ykblSal ysus ds fy, izkFkhZ ds ikl oS/k fl[kykbZ ykblSal gksuk pkfg,A fl[kykbZ ykblSal ds cuus 30 fnu ds ckn ls 180 fnu ds chp esa og vkosnu dj ldrk gSA vkosnd dks okgu iz.kkyh] MªkbZfoax] VSªfQd fu;e vkfn dk tkudkj gksuk pkfg,A iz’u2 LFkkbZ ykblSal dkSu curk gS\ mrj LFkkuh; mi&e.My vf/kdkjh ¼ukxfjd½ ds }kjk LFkkbZ ykblSal cuk;k tkrk gSA iz’u3 LFkkbZ ykblSal dkSu ys ldrk gS\ mrj dksbZ Hkh O;Ld ftlus 18 lky dh vk;q iwjh dj yh gS og MªkbZfoax ykblSal ds fy, ik= gSA iz’u4 LFkkbZ ykblSal fdruh vof/k ds fy, curk gS\ mrj LFkkbZ ykblSal T;knk ls T;knk 20 lky dh vof/k rd cu ldrk gSA iz’u5 LFkkbZ ykblSal cuokus ds fy, D;k&D;k nLrkost yxrs gSa\ mrj 1. QkeZ u0 4 2. QksVksA 3. okLrfod fl[kykbZ ykblSalA 4. fuokl izek.k i=A 5. vk;q izek.k i=A 6. Loa; ?kksf"kr izek.k i=A Qhl ykblSal dh Js.kh LoLF; Qhl lsok ykblSal Qhl VsLV Qhl VksVy Qhl LdwVj@eksVj lkbZdy 200/- 100/- 100/- 50/- 450/- LdwVj@eksVj 200/- 100/- 100/- 100/- 500/- lkbZdy@dkj LdwVj@eksVj 200/- 100/- 100/- 150/- 550/- lkbZdy@dkj@VjsDVj 128

FORM 1 [RULE 5(2)] Application -cum- declaration as to the physical fitness

1 Name of the applicant

2 Son/wife/daughter of

3 Permanent Address

4 Temporary address

Official address (if any)

5 (a) Date of birth

(b) Age on date of application

6 Identification Mark (1)

(2) Declaration: a) Do you suffer from epilepsy, or from sudden attack of loss of consciousness or giddiness from any cause ? Yes/No b) Are you able to distinguish with each eye (or if you have held a driving Licence to drive a motor vehicle for a period of not less than five year & if you lost, the sight of one eye after the said period of five years & if the application is for driving a light motor vehicle other than a transport vehicle fitted with an outside mirror on the steering wheel side) or with one eye, at a distance of 25 meters in good day light (with glasses, if worn) a motor car number plate ?Yes/No c) Have you lost either hand or foot or are you suffering any defect or muscular power of either arm or leg ? Yes/No d) Can you readily distinguish the pigmentary colours, red and green? Yes/No e) Do you suffer from night blindness ? Yes/No 129

f) Are you so deaf as to be unable to hear (and if the application is for driving a light motor vehicle, with or without hearing aid) the ordinary sound signal ? Yes/No

g) Do you suffer from any other disease or disability likely tocause your driving of a motor vehicle to be source of danger to public, if so give detail ? Yes/No

I hereby declare that the best of my knowledge andbelief, the particulars above and the declaration made therein are true.

(Signature or Thumb impression of the applicant)

Note:(1) An applicant who answer ‘Yes’to any the question (a), (c), (e),(f) and (g) or ‘No’to either of the question (b) and (d) should ampligy his answer with full particulars, and may be require to give further information relation there to.

(2) This declaration is to be submitted with medical certificate in Form 1-A. 130

FORM 1-A Medical Certificate

[To be field in by a Registered Medical practitioner appointed by the state Govt. or person authorised in this behalf by the State Govt. referred to under sub-section (3) of section 8]

1. Name of the Applicant

2. Identification Marks (1)

(2)

(a) Does the applicant to the best of your judgment suffer from any defect of vision. If so, has it been corrected by suitable spectacle ? (b) Can the applicant to the best of your judgment readily distinguish the pigmentary colours red& green ? (c) In your opinion, is he able to distinguish with his eye sight at the distance of 25 meters in good day light a motor car number plate ? (d) In your opinion does the applicant suffer from a degree of deafness which would prevent his hearing the ordinary sound signals ? (e) In your opinion does the applicant suffer from night blindness ? (f) Has the applicant any defect or deformity or less of member which would interfere with the efficient performance of his duties as a driver ? If so give your reason in details . (g) Optional

(a) Blood Group of the applicant

(b) RH factor of the applicant (If the applicant so desires that the information may be noted in his driving Licence. Declaration made by the applicant in Form-1 as to his physical fitness is attached

I certify that I have personally examined applicant ...... I also certify that while examining the applicant I have direct special attention to the distance vision and hearing ability, the condition of the arm, legs, hands and joints both extremities of the candidate and to best of my judgment he is medically fit/not fit to hold a driving Licence. 131

The applicant is not medically fit to hold a License for the following reasons:-

Signature

1. Name and the designation of the medical

Space for Officer/Practitioner. passport size photograph 2. Registration number of Medical Officer ......

Signature or thumb impression of the Candidate ......

Date…......

NOTE: The medical officer shall affix his signature over the photograph affixed such a meaner that part of his signature is upon the photograph and part on the certificate. 132

FORM 2 (See Rule 10) FORM OF APPLICATION FOR THE GRANT OR RENEWAL OF LEARNER'S LICENCE

To The Licensing Authority, Space for ______Passport Size Photograph

I hereby apply for a Licence authorising me to drive as a learner, the following motor vehicle(s) :- (a) Motor cycle without gear (b) Motor cycle with gear (c) Invalid carriage (d) Light Motor vehicle (e) Medium goods vehicle (f) Medium passengers motor vehicle (g) Heavy goods vehicle (h) Heavy passenger motor vehicle (I) Road Roller Motor vehicle of description ......

Particulars to be furnished by Applicant

1. Full Name

2. Son/Wife/Daughter of

3. Permanent address (Proof to be enclosed)

4. Temporary address Official address(if any)

5. Date of birth (proof of age to age enclosed)

6. Educational qualification

7. Identification mark(s)

8. Optional-Blood Group RH FACTOR

9. I hold an effective driving Licence to drive (a) Motor cycle/light motor vehicle/medium passenger motor vehicle/medium goods vehicle with effect from 133

10. Particulars of any driving Licence previously held by applicant Whether it was cancelled and if so, for what reason:

11. Particulars of any learner's Licence previously held up in respect of the description of vehicle to which the applicant has applied.

12. Have you been disqualified for holding or obtaining driving Licence or learner's Licence if so, for what reason.

13. I enclose 3 copies of my recent photograph (passport size photograph)

14. I enclose medical fitness certificate dated ...... issued by doctor.

15. I have submitted along with my earlier application of Learner's Licence/enclose the written concent of parents/guardian (in case of applicant being a minor)

16. I enclose driving certificate dated ...... issued by ...... (Name & address of the driving school)

17. I have the fee of the Rs......

18. I am exempted the Medical test under rule of Central Motor Vehicle Rules 1989.

19. I am exempted from the preliminary test under rule 11 (12) of Central Motor Vehicle Rules. 1989. Strike out whichever is inapplicable.

Date ...... Specimen signature or thumb impression of applicant ………………………………………………………………………………………………… ………………………………………………………

Specimen signature or thumb impression of applicant 134

Declaration under sub-section (2) of section 7 of the Motor Vehicle Act. 1988. Shri/Kumari ...... son/daughter of ...... who is a minor under my care and I accept responsibility for his/her driving If at a late date I decide not to accept responsibility for his/her driving shall intimate the licensing authority in writing for a cancellation I give my consent for his/her obtaining learner’s Licence.

Signature …………..……….. Name & Full address of the Parent/guardian...... Relationship…………………..

(To be signed in the presence of the Licensing Authority or person authorized in this behalf by the Licensing Authority)

FOR OFFICE USE ONLY

The applicant is exempted from the medical test under rule 6 and the preliminary test under rule 11 (2) of the Central Motor Vehicle Rules, 1989. Learner's Licence may be issued.

The applicant was tested with reference to rule 11 (1) of the Central Motor Vehicle Rules,1989 he/she has passed I the test. Learner's Licence may be issued.

he/she has failed in the test. (Reasons should be specified) Learner's Licence may be refused.

Signature of Licensing Authority or Other Person authorised in this behalf. 135

FORM 4 (See Rule 14) Form of Application for Licence to Drive a Motor Vehicle

To Space of The Licensing Authority photograph

1 Apply for a Licence to enable me to driver Vehicle of the following description

(a) Motor cycle without gear (b) Motor cycle with gear (c) Invalid carriage (d) Light Motor vehicle (e) Medium goods vehicle (f) Medium passengers motor vehicle (g) Heavy goods vehicle (h) Heavy passenger motor vehicle (I) Road roller Motor vehicle of the following description

Particulars to be furnished by Applicant

1. Full Name … … … … … … … … … … … … … … ...... 2. Son/Wife/Daughter of … … … … … … … … … … … … … … ...... 3. Permanent address … … … … … … … … … … … … … … ...... (Proof to be enclosed) … … … … … … … … … … … … … … ...... 4. Temporary address … … … … … … … … … … … … … … ...... Official address(if any) … … … … … … … … … … … … … … ...... 5. Date of birth … … … … … … … … … … … … … … ...... (proof to be enclosed) … … … … … … … … … … … … … … ...... 6. Educational qualification … … … … … … … … … … … … … … ...... 7. Identification mark(s) … … … … … … … … … … … … … … ...... 8. Optional-Blood Group RH FACTOR … … … … … … … … … … … … … …

9. Have you previously held driving … … … … … … … … … … … … … …

Licence if so give details

10. Particulars and date of ever … … … … … … … … … … … … … … . conviction which has been ordered to be endorse on any L i cense held by applicant 136

11. Have you been disqualified for … … … … … … … … … … … … … … obtaining a Licence to drive if so, for what reason.

12. Have you been subjected to a … … … … … … … … … … … … … … driving test as to your fitness or ability to drive a vehicle in respect of which a Licence to drive is applied for ? If so give the following details.

Date of test Testing Authority Result of test

13. I enclose 3 copies of my recent photograph of the five centimeters into six centimeters (Where laminated card is used on photograph are required).

14. I enclose the learner Licence No ...... Issued by Licensing Authority.

15. I enclose the Driving Certificate No...... Dated ...... Issued by ......

16. I have submitted along with application for Learners Licence the written consent of parents /guardian.

17. I have submitted along with application for Licence/enclose the medical certificate

18. I enclose form the Medical test under rule 6 of Central Motor Vehicle Rule 1989.

19. I am examined from the preliminary test under rule (2) of Central Motor Vehicle Rules. 1989.

20. I have paid the fee of rupees.

I have by declare the best of my knowledge and behalf the particulars give above and

Note - Strike out whichever in applicable.

Date ......

Signature or thumb impression of applicant 137

Certificate of test of competent to driver

The applicant has passed the test prescribed under the rule 15 of the Central Motor vehicle Rules 1989. The test conducted on (enter the registration trade and description of the vehicle ...... on date

The applicant has failed in the test (The details of deficiency to be listed out)

Date ...... Signature of testing Authority

Full name & designation

Two specimen signature of applicant 138

FORM 1 [RULE 5(2)] Application -cum- declaration as to the physical fitness

1 Name of the applicant

2 Son/wife/daughter of

3 Permanent Address

4 Temporary address

Official address (if any)

5 (a) Date of birth

(b) Age on date of application

6 Identification Mark (1)

(2)

Declaration: a) Do you suffer from epilepsy, or from sudden attack of loss of consciousness or giddiness from any cause ? Yes/No b) Are you able to distinguish with each eye (or if you have held a driving Licence to drive a motor vehicle for a period of not less than five year & if you lost, the sight of one eye after the said period of five years & if the application is for driving a light motor vehicle other than a transport vehicle fitted with an outside mirror on the steering wheel side) or with one eye, at a distance of 25 meters in good day light (with glasses, if worn) a motor car number plate ?Yes/No c) Have you lost either hand or foot or are you suffering any defect or muscular power of either arm or leg ? Yes/No d) Can you readily distinguish the pigmentary colours, red and green? Yes/No e) Do you suffer from night blindness ? Yes/No 139

f) Are you so deaf as to be unable to hear (and if the application is for driving a light motor vehicle, with or without hearing aid) the ordinary sound signal ? Yes/No g) Do you suffer from any other disease or disability likely tocause your driving of a motor vehicle to be source of danger to public, if so give detail ? Yes/No

I hereby declare that the best of my knowledge andbelief, the particulars above and the declaration made therein are true.

(Signature or Thumb impression of the applicant)

Note:(1) An applicant who answer ‘Yes’to any the question (a), (c), (e),(f) and (g) or

‘No’to either of the question (b) and (d) should ampligy his answer with full

particulars, and may be require to give further information relation there to.

(2) This declaration is to be submitted with medical certificate in Form 1-A. 140

FORM 1-A Medical Certificate

[To be field in by a Registered Medical practitioner appointed by the state Govt. or person authorised in this behalf by the State Govt. referred to under sub-section (3) of section 8]

1. Name of the Applicant

2. Identification Marks (1)

(2)

(a) Does the applicant to the best of your judgment suffer from any defect of vision. If so, has it been corrected by suitable spectacle ? (b) Can the applicant to the best of your judgment readily distinguish the pigmentary colours red& green ? (c) In y o u r opinion, is he able to distinguish with his eye sight at the distance of 25 meters in good day light a motor car number plate ? (d) In your opinion does the applicant suffer from a degree of deafness which would prevent his hearing the ordinary sound signals ? (e) In your opinion does the applicant suffer from night blindness? (f) Has the applicant any defect or deformity or less of member which would interfere with the efficient performance of his duties as a driver? If so give your reason in details. (g) Optional

(a) Blood Group of the applicant

(b) RH factor of the applicant (If the applicant so desires that the information may be noted in his driving License. Declaration made by the applicant in Form-1 as to his physical fitness is attached

I certify that I have personally examined applicant ...... I also certify that while examining the applicant I have direct special attention to the distance vision and hearing ability, the condition of the arm, legs, and hands and joints both extremities of the candidate and to best of my judgment he is medically fit/not fit to hold a driving License.

The applicant is not medically fit to hold a License for the following reasons:- 141

Signature

1. Name and the designation of the medical Officer/Practitioner. Space for passport size photograph 2. Registration number of Medical Officer ......

Signature or thumb impression of the Candidate ......

Date…......

NOTE: The medical officer shall affix his signature over the photograph affixed such a meaner that part of his signature is upon the photograph and part on the certificate. 142

Form 9 [See Rule 18 (1)]

Form of application for the renewal of Driving License I Shri/Smt/Kumari ...... Son/Wife/Daughter of ...... hereby apply the renewal of my

DRIVING LICENCE.

(a) Number … … … … … … … … … … … … … … … … … … (b) Date of issue … … … … … … … … … … … … … … … … … … (c) Licensing Authority by which the … … … … … … … … … … … … … … … … … … (d) License was issued … … … … … … … … … … … … … … … … … … (e) Licensing Authority by which the … … … … … … … … … … … … … … … … … … (f) License was renewed … … … … … … … … … … … … … … … … … … (g) No. and Date of renewal … … … … … … … … … … … … … … … … … … (h) Class of vehicle authorised to be driven … … … … … … … … … … … … … … … … … ……. (i) Date of expiry of License to drive … … … … … … … … … … … … … … … … … (j) (I) Transport Vehicle … … … … … … … … … … … … … … … … … (ii)Vehicles other than transport vehicles … … … … … … … … … … … … … … … … … M present address is … … … … … … … … … … … … … … … … … … ………… … … … … … … … … … … … … … … … …

Driving License which is attached and particulars of which are follows

If this address is not entered on the License I do/do not wish that it should be entered......

If this address is not attached, reasons why it is not alive? ...... If the License was not renewed within thirty days of the date of expiry reason for delay. The renewal of License has not been refused by any Licensing Authority. I have not been disqualified for holding or obtaining a driving License . My License has not been revoked. I enclosed a Medical fitness Certificate Form 1 -A. I enclosed three copies of my recent passport photographs. I have paid the fee of Rs. I hereby declare that to the best of my knowledge & belief given above are true.

Date… … … … … . Signature or thumb impression 143

LL.D. FORM

Application for the issuance of the duplicate driving License as per rules of the Punjab Motor Vehicles Act and rules made there under

To The Licensing Authority Motor Vehicles, ......

Sub: Issuance of Duplicate Driving License.

Sir,

It is respectfully submitted that the driving License being

No………………………. issues by the licensing Authority,………………… has been lost/damaged/misplaced by me.

The requisite court fee stamp of Rs ……………………………………………………… is affixed on this application and the said License is not involved in any Challan or for

Dated ……………….

Signature of Applicant 144

FORM 20 (See Rule 47) (Form of Application for Registration of a Motor Vehicle)

To The Registering Authority, …………………………..

1. Full name of the person to be registered as registered owner, S/o, D/o, W/o

2. Age of the person to be registered as registered owner (Proof of age to be attached)

3. Permanent address of the person to be registered as registered owner

4. Temporary address of the person to be registered as registered owner

5. Name and address of the Dealer or Manufactured from whom the vehicle was purchased (Sale certificate a n d certificate of road worthness issued by the manufacturer to be enclosed)

6. If ex-army vehicle or imported vehicle enclose proof of locally manufactured trailor/semi trailor enclose the approval of design by the State Transport Authority and not the preceeding number and date of approval.

7. Class of vehicle (If motorcycle, with or without gear)

8. The Motor vehicle is a) a new vehicle b) Ex-army vehicle c) imported vehicle 145

9. Type of body

10. Type of vehicle

11. Maker's Name

12. Month & year of manufacture

13. Number of cylinders

14. Horse power

15. Cubic Capacity

16. Maker's Classification or in not known wheel base

17. Chassis number (Affix pencil print)

18. Engine number

19. Seating capacity (including driver)

20. Fuel used in engine

21. Unladen weight

22. Particulars of previous registration and registered no, if any

23. Colour or colours of body, wings and front end

I hereby declare that the vehicle has not been registered in any State in India. Additional particulars to be completed only in the case of transport vehicle other than motor car.

24. Number description and size of tyres

a) Front b) Rear Axle c) Any other axle d) Tandem axle 146

25. Gross vehicle weight

a) as certified by the manufacturer b) to be registered

26. Maximum axle weight

(a) Front axle (b) Rear axle (c) any other (d) Tandem axle

27. (a) Overall length (b) Overall length (c) Overall height (d) Over hang

The above particulars are to be filled in a rigid frame motor vehicle of two or more axle foran articulated vehicle of three or more axle or to the extent applicable for trailer where a second semitrailer of additional sumbe registered with an articulate motor vehicle the following particulars are to be furnished for each such semitrailer.

28. Type of body 29. Unladen weight 30. Number of description and size of tyres on each axle ______31. Maximum axle weight in respect of each axle 32.The vehicle is covered by a valid certificate of insurance under chapter XI of the Act

No date of (name company)

33. The vehicle is exempted from Insurance. The relevant Valid for on ...... to ..... order is enclosed

34. I have paid the prescribed fee or rupee

Date ...... Signature of the person to be registered as registered Owner 147

Note: The motor vehicle above described is (I) Subject to hire purchase agreement of lease agreement with ...... (II) Subject to hypothecation in favour of ...... (III) Not held under hire purchase agreement of lease agreement or subject to hypothecation.

Strike out whichever is inapplicable if this subject to such the agreement the signature of the person with whom such agreement has been entered in, is to be obtained.

Signature of person with whom an agreement of Signature of the owner

Hire purchase lease or hypothecation has been entered into Spacemen signature of the person to be registered as registered owner (1) (2) (3)

CERTIFICATE Inspected the vehicle

Certified that the particulars contained in the application are true and that the vehicle compiles with the requirements of the Motor Vehicle Act 1988 and the Rule made there under. Signature of the authority Name ……………………………………….. Designation ......

For office endorsement

Ref. No...... Office of the ...... Date ......

The ...... bearing chassis number ...... and engine ...... has been assigned the registration under the registered in the name ...... and the vehicle is subject to an agreement of hire purchase/lease/hypothecation ......

Registering Authority (Name and address of the financer)

File name: form20.doc 148

FORM 28 Application for and grant of no objection certificate See Rule 54, 58(1) (3) and (4)

Form of application for No Objection and grant of certificate to be made in triplicate, the duplicate copy and the triplicate copy with the endorsement of the registering authority to be returned to the owner of the vehicle and the registering authority in whose jurisdiction the vehicle is to be removed, respectively)

PART-1

To The Registering Authority, Motor Vehicle......

I/we intent to transfer the vehicle to the jurisdiction of thereof the Registering Authority......

I/we intend to the sell the vehicle to Shri/Smt/Kumari...... who resides in the jurisdiction of the Registering Authority...... of the State of ...... I/we therefor request for the issue of a no objection certificate for my/our vehicle the particulars of which are furnished:-

1. Name and address 2. Son/wife/daughter of 3. Registration number of the vehicle. 4. Class of vehicle 5. Registration Authority which originally registered the vehicle 6. Engine number 7. Chassis number-Affix pencil print 8. Period of stay in the state 9. Period up to which motor vehicle tax has been paid. 10. Whether any demand fox tax is pending, if so, 11. Whether the vehicle is involved in the theft cases, if so, give details 12. Whether any action under section 53, 53, or 55 of the motor vehicle Act 1988 is pending before, any Registering Authority or other prescribed authority if so, give details 13. Whether the vehicle is involved in any case of transport of prohibited goods, if so, give details. I/we solemnly declare that above statement is true 14. Permit Number (in case of Transport Vehicle) 15. Whether the Vehicle is held an agreement of hire purchase? (if so, name of the concerned be mentioned) 149

PART-II

(Grant/refusal of No objection Certificate, under sub-section 3 of section 48 of M.V.Act.1988)

(I) No Objection Certificate in respect of the vehicle the detailed particulars whereof recorded overleaf is hereby granted under section 48 (3) of M.V.Act. 1988

(ii) No objection Certificate in respect of the vehicle the detailed particulars thereof recorded overleaf is hereby refused under section 48 (3) of M.V. Act. 1988 for the reasons recorded as under:

......

Signature with seal of Registering Authority Date...... Address......

To ...... (Registered owner) copy in the registering authority (By registered post of delivered under proper acknowledgment) Strike out whichever is in applicable 150

PART-III

Office Endorsement

No ……………………………………………………… Date ……………………….. office of the ………………………………………………..

Acknowledgment for the receipt of application for No objection certificate

The application dated...... from...... (Name and Address) for the grant of a “No objection C e r t i f i c a t e i n r e s p e c t of vehicle number...... has been r e c e i v e d o n ...... a n d i s u n d e r c o n s i d e r a t i o n

Date...... Signature of Registering Authority of the person authorized by him Official Seal......

To ...... (Registered Owner) By registered post of delivered under proper acknowledgment 151

Form 26 (See Rule 53)

Intimate of loss or destruction etc. of the Certificate of Registration and application for the issue of duplicate Certificate of Registration.

(To be made in duplicate if the vehicle is held under an agreement of hire purchase/ hypothecation/ lease and the duplicate copy with the endorsement of Registering Authority to be returned to the Registering Authority......

Sir,

The Certificate of Registration of my/our Motor Vehicle the Registration Mark of which is ...... has been lost/destroyed/completely written off/soiled /tern/multilated in t h e following circumstances...... I/we hereby declare that the best of my/our knowledge the registration of the vehicle has not been suspended or cancelled under the provisions of the Act. or rules made there under and the circumstances explained above are true. I/we h e r e b y a p p l y f o r t h e i s s u e of a d u p l i c a t e c e r t i f i c a t e o f Registration. The w r i t e a off/soiled/torn/ multilated Certificate of registration is enclosed. The vehicle is not held under any agreement of her-purchase/leas/hypothecation. I/We have reported the loss to Police Station on ...... (date).

Date ...... Signature/Thumb impression of applicant along with full address

Strike out whichever is inapplicable. The vehicle is hold under hire purchase/lease/hypothecation agreement with ...... and the No Objection Certificate obtained from the financier. (Where ‘No Objection Certificate’ is not enclosed applicant shall make a declaration as required sub-section (8) of Section (51).

Signature of the owner Name … ...... Full Address ...... 152

Specimen signature of the owner (1)

Note:- (1) Full particulars of the circumstances shall be furnished in the case of lose or ditruction of the Registration Certificate. (2) Strike out whichever is inapplicable.

For Office Endorsement Number ...... Date...... Office of the ...... A duplicate Certificate of registration as requested above is issued with the note agreement of hire purchase/lease/hypothecation on ……… and is noted in the original registration. Record in Form 24.

Signature of the registering Authority

To ...... (Name and address of the financier By registered post or delivery under proper acknowledgement 153

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Ø-la- 'kSf{kd ;ksX;[email protected] 1.4.09 ls ykxw la’kksf/kr njsa (amended)

1. 10+2 o mlls vf/kd ;ksX;rk ¼xSj foKku 500/- izfrekl fo"k;ksa ds iq:"k½

2. 10+2 o mlls vf/kd ;ksX;rk ¼foKku fo"k;ksa ds 750/- izfrekl iq:"k½ 155

3. 10+2 o mlls vf/kd ;ksX;rk ¼lHkh efgyk,sa½ 900/- izfrekl

4. Lukrd o mlls vf/kd ;ksX;rk ¼xSj foKku 750/- izfrekl fo"k;ksa ds iq:"k½

5. Lukrd o mlls vf/kd ;ksX;rk ¼foKku fo"k;ksa 1000/- izfrekl ds iq:"k½

6. Lukrd o mlls vf/kd ;ksX;rk ¼lHkh efgyk,sa½ 1500/- izfrekl 156

DEPARTMENT OF EMPLOYMENT HARYANA

EMPLOYMENT EXCHANGE ____

APPLICATIION FOR UN EMPLOYMENT ALLOWANCE

1. Name of the applicant 2. Father’s Name Spouse Name 3. Registration No and Date 4. N.C.O. No. 5. Complete residential address

6. Date of Birth

Detailsofexamination passed YearofPassing Nameof Board/UM Matric ,10+2 OR any other 2Year certificate/diploma course after Matric. Graduation degree OR above OR 3year certificate/diploma after 10+2

Whether Husband /Wife is employed Yes/No Family annual income from all sources ______Familyannual income fromallsources Familyannual income fromallsources (For Married female candidates) Father Father-in –Laws Mother Mother-in –Laws Wife Husband Brother Brother -in-Laws Sister Sister-in-Laws

Total Income

DetailofProperty Area Location Value (i) Residential Property (ii) Commercial Property (iii) Agriculture Land Signature of the applicant Dated Signature/Thumb impression of the of the Family 157

Verification about commercial/ Verification about commercial/residential Residential property by Patwari/ property by Tehisldar /Naib Tehsildar Municipal Official /E.O.M.C

For office use Attestation of residential or commercial property by Sub Name of the Bank & A/C No.______Divisional Officer (Civil) 158

Affidavit I______S/o,D/o,W/o Sh. ______Resident of______solemnly affirm and declare that

1. I am an unemployed and a domicile of Haryana State. 2. I have passed my ______examination from ______Board/University/Institution recognized by Haryana Govt. 3. I am registered with the Employment Exchange ______Registration No.______from dated______and my name is continuing. 4. My annual family income from all sources including that of spouse does not exceed Rs.50,000/- or the family does not have residential or commercial property exceeding Rs. 10.00 lacs in value or agricultural land in excess of 2 hectares. 5. I am in the age group of 21-35 years. 6. I am not a student /trainee/apprentice. 7. My wife/husband is not an employee. 8. I am not self-employed. 9. I am not a dismissed Govt. employee. 10. I have not been convicted of any offence resulting in imprisonment for a period of six months or more. 11. I shall stop receiving the allowance and inform the department of employment and the concerned bank branch in case of my becoming ineligible for unemployment allowance. I further undertake to refund the whole amount received by me with interest, for any period for which I am found ineligible, as decided by the Govt.

Place:

Date: Deponent

Verification

I solemnly declare that all the facts given above are true to the beat of my knowledge and belief and nothing has been concealed.

Place:

Date: Deponent 159

Affidavit

I ______S/o, D/o, W/o Sh.______Resident of ______solemnly affirm and declare that:-

1. I am still unemployed. 2. I will inform the Employment Exchange immediately as and when I get a job through my own efforts/ Employment Exchange 3. THE VALUE OF COMMERICIAL/residential property of my parents does not exceeds Rs.10 lacs. 4. I will repay the excess mount if any paid to me by Employment e xchange. 5. I am not taking unemployment from any other Employment Exchange.

Place: Date: Deponent

Verification

I solemnly declare that all the facts given above are true to the beat of my knowledge and belief and nothing has been concealed.

Place: Date: Deponent 160

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Ikz’u1: ofj"B ukxfjd fdls dgrs gSa ? mRrj% dksbZ Hkh O;fDr ;k efgyk ftlus lkB o"kZ dh vk;q iwjh dj yh gks og ofj"B ukxfjd dgykrk gSA Ikz’u2: ofj"B ukxfjd ds igpku i= dk D;k vfHkizk; gS ? mRrj% igpku i= ofj"B ukxfjd dh vk;q dk izek.k i= gSA Ikz’u3: ofj"B ukxfjd ds fy,s igpku i= dk vkosnu dgka fd;k tkrk gS ? mRrj% igpku i= cuokus ds fy,s O;fDr }kjk ftyk lekt dY;k.k vf/kdkjh ds dk;kZy; esa vkosnu i= nsuk gksrk gSA Ikz’u4: ofj"B ukxfjd igpku i= cuokus ds fy,s dkSu ls nLrkost dh t:jr gksrh gS ? mRrj% igpku i= ds fy,s fuEufyf[kr nLrkostksa dh vko’;drk gksrh gSA 1. rlnhd dh gqbZ jk’ku dkMZ dh dkih 2. nks QksVks 3. rlnhd fd;k gqvk vk;q izek.k i= 4. rlnhd fd;k gqvk oksVj dkMZ Ikz’u5: ofj"B ukxfjd igpku i= fdl vf/kdkjh }kjk cuk;k tkrk gS ? mRrj% ofj"B igpku i= ftyk lekt dY;k.k vf/kdkjh dh laLrqfr (Recommendation) ij lacaf/kr mi&e.My vf/kdkjh ¼ukxfjd½ }kjk cuk;k tkrk gSA Ikz’u5: ofj"B ukxfjd igpku i= dk iz;ksx dgka ij gksrk gS ? mRrj% ofj"B ukxfjd igpku i= ofj"B ukxfjdksa }kjk muds dY;k.k ds fy, Hkkjr ljdkj vkSj gfj;k.kk ljdkj }kjk ?kksf"kr dh xbZ dbZ izdkj dh ;kstukvksa dk Qk;nk mBkus ds fy, gksrk gSA 161

APPLICATION FORM FOR ISSUANCE OF SENIOR CITIZEN IDENTITY CARD/ RENEWAL OF IDENTITY CARD.

Photo Photo

1. Name ...... 2. Father’s/Husband’s Name ...... 3. Date of birth/Age ...... 4. Whether domicile of Haryana ...... 5. Permanent Address ...... 6. Whether belongs SC/ST/BC ...... Ex-serviceman 7. Whether belongs to minority ...... 8. Whether your name appear in ...... the BPL list of so then indicate BPL No. 9. Whether getting Old Age ...... Allowance/Handicapped Pension Government ? 10. In case of renewal, furnish following information :- a) Identity Card No...... b) Date of issuance of I/card ...... c) Date of expiry of the I/card ...... d) Name of Issuing authority ......

Place : HISAR Signature of the Applicant Date :

Enclose :- following documents Contact No...... 1.copy of ration card Attested 2.Two Photo 3.Age proof Certificate Attested 4.copy of Voter Card Attested 162

Following Legal care and Support Centres have been established by Haryana State Legal Services Authority for reaching out to the masses in the State of Haryana:-

A. Permanent Legal care and Support Centres /Legal Aid Cells in Jail Haryana State Legal Services Authority has established Legal care and Support Centres /Centres in all the Jails/Sub Jails of Haryana. The Advocates empanelled under the ‘Legal Aid Counsel’ scheme, regularly visited Central/District Jails/Sub Jails, at specified intervals, as deputed by District Legal Services Authorities and Sub-Divisional Legal Services Committees, for giving legal advise to the accused/convicts, if the need be, and collecting their applications/representations, if any and to submit the same to the concerned courts on the next working day.

B Village Legal care and Support Centres in Villages Under NALSA (Legal Aid Clinic) Regulations, 2011, Legal Aid Clinics are required to be set up in all the villages or cluster of villages. HALSA has already established 267 Village Legal care and Support Centres in different villages of all the Districts of Haryana. The Legal Aid Counsel/Para Legal Volunteers attend Legal care and Support Centres on the scheduled dates for providing legal aid to the litigants visiting these Permanent Legal care and Support Centres.

C Permanent Legal care and Support Centres in Courts

D. Permanent Legal care and Support Centres in Law Colleges & Universities

E. Legal care and Support Centres in the offices of Protection Officers appointed under Protection of Women from Domestic Violence Act, 2005.

F. Legal care and Support Centres in Primary Health Centres/ Urban Areas/Community Centres 163

LIST OF LEGAL CARE AND SUPPORT CENTRES ESTABLISHED IN THE STATE OF HARYANA TILL DATE

Sr. Name of Legal Legal Village Legal care Legal Legal No District care and care Legal care and care care Tota . Authorities Support and and Support and and l Centres Suppor Support Centres in Suppor Suppor in the t Centres in Primary t t Offices of Centre Gram Health Centre Centre Protectio s in Panchayat Centers/ s in s In n Officers Jails s Urban Law Distt. Areas/com College Court -munity Centers etc. Ambala 1 1 9 2 2 1 16 1 Naraingarh Bhiwani 1 1 20 6 0 1 29 Charkhi Dadri 2 Loharu Siwani 3 Faridabad 1 1 6 3 2 1 14 Fatehabad 1 19 5 2 27 4 Ratia Tohana Gurgaon 1 1 12 4 1 1 20 5 Pataudi Sohna Hissar 1 2 12 8 4 1 28 6 Hansi Jind 1 1 15 4 1 22 7 Narwana Safidon Jhajjar 1 1 6 3 1 12 8 Bahadurgarh Kurukshetra 1 1 17 8 2 1 30 9 Pehowa Karnal 1 1 23 4 1 30 10 Assandh Kaithal 1 1 12 4 1 19 11 Gulha Mewat at Nuh 1 11 2 14 12 Ferozpur Zhirkha Narnaul 1 1 6 11 1 1 21 13 Mahendergar h 164

Palwal 1 1 12 6 2 22 14 Hodal Panipat 1 1 16 3 1 1 23 15 Samalkha Panchkula 1 13 7 2 23 16 Kalka Rohtak 1 1 3 1 4 1 11 17 Meham Rewari 1 1 10 8 1 2 23 18 Kosli Sirsa 1 1 22 2 4 1 31 19 Ellenabad Sonepat 1 1 15 2 2 3 24 20 Gohana Ganaur Yamuna 1 1 10 4 2 18 21 Nagar Bilaspur

Total 21 19 269 95 24 29 457 165

LEGAL CARE AND SUPPORT CENTRES IN GRAM PANCHAYATS AND URBAN AREAS OF HARYANA

Sr. Name of No. of Legal Name of villages where No. District care and Legal care and Support Centres Support established Centres Established 1 Ambala 10 villages 1. Durana Naraingarh 5 Villages 2. Barara Urban Areas 2 3. Talheri Gujran 4. Panjhkora 5. Mithapur 6. Naggal 7. Manka 8. Adhoya-H, 9. Anandpur 10. Saha Urban Areas 1. Observation Home/Special Home, Ambala. 2. S.P. Office, Ambala City (Protection Office) Naraingarh 1. Badholi 2. Badi Bass 3. Shehzadpur 4. Lotton 5. Hussani 2 Bhiwani 17 villages 1. Palwas Charkhi Dadri 2 Villages 2. Tigrana Loharu 4 Villages 3. Jatu lohari siwani 2 villages 4. Bapora urban areas 2 5. Kanut 0 6. Dhana Ladanpur 7. Dhanana 8. Devsar 9. Chang 10. Sui 11. Biran 12. Alakpura 13. Dhana Narsan 14. Kharak 15. Bamla 16. Dhani Mahu 17. Bajina Urban Areas Loharu 1. Singhani 2.Dhigawa Charkhi Dadri 1. Bond Kalan 2. Jhojhu Kalan 3. Ghasola 4. Badhra Siwani 1. Barwa 2. Gurera 166

3 Faridabad 08 villages 1. Tilpat Urban Area 03 2. Palwali 3. Bhatola 4. Tigaon 5. Badoli 6. Faridpur 7. Tikawali 8. Neemka Urban areas 1. Ashoka Enclave 2. Dabua Colony 3. N.I.T. Faridabad

4 Fatehabad 14 villages 1. Dhingsara Tohana 05 villages 2. Dhanger Ratia 04 villages 3. Bhirdana Urban areas 06 4. Gorakhpur 5. Chinder 6. Dariyapur 7. Ramsara 8. S. P. Daroli 9. Jandlikalan 10. Buwan 11. Mehuwala 12. Hizrawan Khurd 13. Ayalki 14. Khan Mohammad Urban Areas 1. Civil Hospital, Health centre Tohana 1. Kanhari 2. Simbalwala 3. Sakkerpura 4. Jamalpur 5. Jakhal Urban Areas 1. Raj Nagar, Aanganwari Center 2. Balmiki Mohalla, Aanganwari Cente 3. Samain, Community Center Ratia 1. Lalli 2. Haroli 3. Aherwan 4. Nangal Urban area 1. Bislan Dharmshala 2. Dhani Shergarh 167

5 Gurgaon 10 villages 1. Navada Urban areas 02 2. Wajirpur Faruk Nagar 1 3. Badha 4. Shikohpur 5. Badshapur 6. Bhangrola 7. Bar gujar 8. Wazirabad 9. Bhondsi 10. Haily mandi Urban Areas 1. Secret, Protection Home 2. DLF-1

Faruk Nagar 1. Recreation center-cum-library at faruk Nagar. 6 Hisar 07 villages 1. Mirjapur Hansi 05 villages 2. Pabra Urban areas 08 3. Moda Khera 4. Kirmara 5. Muklan 6. Badhawar 7. Kabrel

Urban areas 1. Urban RCH Centre, Azad Nagar, Hisar. 2. Urban RCH Centre, Ghoda Farm, Hisar(Balsamand Road) 3. Urban RCH Centre, Surya Nagar, Hisar. 4. Bus Stand (city), Hisar. 5. Protection Officer for newly Wedded Couple, Red Cross Society, Hisar. 6. Observation Home, Hisar. 7. S.P Nodal Cell, Hisar. 8. Rajeev Gandhi Sewa Sadan, Hisar. Hansi 1. Garhi 2. Sisar 3. Madha 4. Depal 5. Petwar

7 Jind 07 villages 1. V. Nagura Safidon 06 villages 2. V. Gatauli Narwana 05 villages 3. V. Quila Zafargarh Urban Areas 02 4. V. Jhanjh Kalan 5. V. Rajpura 6. V. Manoharpur 7. V. Kandela Urban area 1. Safidon 1. Pillukhera 2. Budha Khera 3. Hatt 4. Karkhana 5. Paju Kalan 6. Muwana 168

Urban areas 1. Community Centre Narwana 1. Bailerkhan 2. Baroda 3. Dumerkhan Kalan 4. Dhani 5. Dharodi Urban areas 1. General Hospital Narwana

8 Jhajjar 07 villages 1. Dighal Shahid Urban Areas 03 2. Matanhail Bahadurgarh 3 villages 3. Dubhaldhan 4. Sahlawas 5. Chuchakwas 6. Dujana 7. Dadri Toi Urban areas 1. School No.1 Jhajjar 2. Govt. Boys Sr. Sec. Bhatti Gate Jhajjar 3. Opposite Bus Stand, Jhajjar. Bahadurgarh 1. Jassaur 2. Mandothi 3. Badli 9 Kurukshetra 11 villages 1. Umri Pehowa 08 villages 2. Dhurala Urban areas 08 3. Mathana 4. Jyotisar 5. Kirmach 6. Nawarsi 7. Kalsana 8. Ban 9. Berthala 10. Barna 11. Landi Urban areas 1. M.C.Thanesar (Fauji Colony) 2. M.C.Thanesar(Layal Pur Colony) 3. Ashadeep Institute for mentally retarded children, vill. Kheri Markanda 4. Prerna (Old Age Home), Salarpur Road, 5. Shashwatanand Ashram, near Court Complex and Sarthak School for Deaf and Dumb Children, Sunderpur Road. 6. Sarthak School for Deaf and Dumb Children, Sunderpur Road. 7. O/O Distt. Social Welfare, 8. HUDA, Pehowa 1. Kalsa 2. Bhatt Majra 3. Thol 4. Diwana 5. Ismailabad 6. Bodhni 7. Urnai 8. Sarsa 169

10 Karnal 22 villages 1. Garhi Jattan Assandh 04 villages 2. Shergarh Khalsa Urban areas 04 3. Bibipur Jattan 4. Garhi Birbal 5. Raitkhana 6. Kutail 7. Barsat 8. Jundla 9. Bansa 10. Baragaon 11. Kunjpura 12. Daha 13. Kheri Man Singh 14. Shekhpura Jagir 15. Kambopura 16. Uncha Samana 17. Shamgarh 18. Bairsal 19. Butana 20. Padhana 21. Sandhir 22. Nidhana Urban areas 1. Nari Niketan 2. Sai Mandir, Sec-6 3. Jal Ghar, Behing Fire Birdage, Tubewell No.20, Jundla Gate 4. Sant Siri Guru Ravi dass mandir, Vakil Pura, Behind Novelty cinema Hall, Assandh 1. Ballah 2. Salwan 3. Ardana 4. Phaphrana 170

11 Kaithal 11 villages Gulha 04 villages 1. Padla Urban areas 04 2. Guliyana 3. Naina 4. Dhand 5. Habri 6. Badsikri Kalan 7. Kalayat 8. Fatehpur 9. Keorak 10. Rajound 11. Siwan Urban Areas

1. Sanatan Dharam Mandir, Kaithal, 2. Dogran Gate, Kaithal 3. Central Public School, Khurana Road, Kaithal 4. Shakti Nagar, Kaithal

Gulha 1. Arnoli 2. Taranwali 3. Rasoolpur 4. Bhuna

12 Mewat at Nuh 11 villages 1. Ferozepur Namak 2. Mohd. Pur Ahir(Tauru) 3. Indri 4. Ujina 5. Indana 6. Saral 7. Sikrawa 8. Singar 9. Meoli 10. Beewan 11. Doha

13 Narnaul 5 Villages Mahendergarh 3 villages 1. Niwaj Nagar Urban areas 11 2. Salimpur 3. Choudhary 4. Jorasi 5. Siarpur Mehta Urban area

1. PHC Sirohi Bahali, Block Nangal Chaudhary 2. PHC Budhwal, Block Nangal Chaudhary 3. PHC Bayal, Block Nangal Chaudhary 4. PHC Balaha Kalan, Block Narnaul 5. PHC Rampura 6. PHC Dochana, Block Narnaul 7. PHC, Musnota 8. BD&PO Block Nangal Choudhary 9. Blind School, Narnaul, Mahendergarh 171

1. Dhanoda 2. Satnali 3. Sehlang Urban areas 1. PHC, Nangal Sirohi 2. PHC, Kanina

14 Palwal 14 villages 1. Alah Pur Hodal 02 villages 2. Asaoti Hathin 02 villages 3. Baghola 4. Behrola 5. Devli 6. DurgaPur 7. Dhola Garh 8. Janoli 9. Khusli Pur No.2 10. Mindkola 11. MandKol 12. Naya Gaon 13. Ronija 14. RaiPur Hodal 1. Benchari 2. Mitrol Hathin

1. Rupraka 2. Manpur

15 Panipat 16 villages 1. Babarpur Urban areas 05 2. Siwah 3. Babail 4. Bapouli 5. Israna 6. Naultha 7. Ahar 8. Mandi 9. Matlauda 10. Khandra 11. Samalkha 12. Manana 13. Chulkana 14. Jaurasi Khalsa 15. Sanouli Khurd 16. Atta Urban areas 1. Kabri Fatak 2. Ekata Vihar Mandir Ujha Road, Panipat 3. Primary Health Centre ,Raj Nagar, Panipat. 4. Urabn Rural Child Health Dispensary, Sec- 29, Flora Chowk, Panipat 5. Parshuram Mandir, Parshuram Colony, Near Wadhawa Ram Colony

16 Panchkula 08 villages Kalka 04 villages 1. Ramgarh urban 5 2. Mouli 3. Mandana 172

4. Morni 5. Nada 6. Bhoghpur 7. Saketri 8. Bir Ghaggar,

Urban areas 1. Mansa Devi Complex, 2. Jatt Dharmshala Main Road, Barwala, 3. Sec 25 Senior Citizen Club 4. Sector 9 Arya Samaj mandir 5. Raipur Rani.

Kalka

1. Mailan 2. Janeh 3. Raipur 4. Govt. Sr. Sec. School (Main Road Kalka)

17 Rohtak 05 villages 1. Brahamnwas Meham 00 2. Lahli Urban areas 4 3. Basana 4. Makroli Khurd 5. Kharawar Urban area

1. Sampla in Municipal Committee 2. S.P.Office, 3. Senior Citizen Club, Sector 3, Rohtak 4. Protection Officer S.P.Office Rohtak

18 Rewari 09 villages 1. Kharkhra Kosli 03 villages 2. Bikaner Urban areas 07 3. Saharanwas 4. Bithwana 5. G.T. Khori 6. Seeha 7. Nehchana 8. Mangleshwar 9. Peethanwas Urban areas 1. Civil Hospital Rewari. PHC 2. Dharuhera 3. Bharawas 4. Khol 5. Kasola 6. Sangwari 7. Bawal Kosli 1. Nagal Pathani 2. Ratan Thal 3. Bhakli

19 Sirsa 23 villages 1. Panihari Urban areas 02 2. Bhavdeen 3. Sikanderpur 4. Bajekan 5. Bansudhar 173

6. Kelnia 7. Nagoki 8. Mallewala 9. Baragudha 10. Panjuana 11. Ding 12. Arniyawali 13. Nathusari Kalan

Urban Area 1. Youth hostal, Shaheed Bhagat Singh Stadium, Sirsa. 2. Child welfare Committee Sirsa. Ellenabad 1. Bhuratwala 2. Ottu 3. Kaherwala 4. Beharwala 5. Kuttabadh Dabwali 1. Abusshahar 2. Kalanwali 3. Haibuana 4. Odhan 5. Kheowali

20 Sonepat 10 villages Gohana 07 villages 1. Dewroo Ganaur 04 2. Murthal Urban Areas 2 3. Juan 4. Mahara 5. Badwasni 6. Bahalgarh 7. Rasoi 8. Bindroli 9. Nahara 10. Sisana Urban areas 1. General Hospital, Sonepat (Town) 2. GVM Girls College, Sonepat (Town)

Gohana

1. Busana, 2. Baroda 3. Thuthan, 4. Butana 5. Khetlan, 6. Bichpari 7. Baroda

Ganaur 1. Garhi 2. Jhajhara, 3. Pugthala 4. Gumar

21 Yamuna Nagar 11 villages 1. Fatehpur Urban Areas 05 2. Sugh 174

3. Orangabad 4. Alahar 5. Kail 6. Tajak Pur 7. Buria 8. Sehajadpur 9. Sankhera 10. Chhachhrauli 11. Sadhaura Urban areas 1. E.S.I . Hospital, Jagadhri. 2. Civil Hospital, Jagadhri, near Old Tehsil premises. 3. Govt. Sr. Sec. School, Jagadhri Workshop 4. Govt. Sr. Sec. School, Model Town Yamuna Nagar. 5. Govt. Girls Sr. Sec. School, Old Sabzi Mandi, Yamuna Nagar. 175

THE LEGAL CARE AND SUPPORT CENRES ESTABLISHED IN LAW COLLEGES AND UNIVERSITIES IN THE STATE OF HARYANA

Rewari Legal care and Support Centre Established in Smt. Shanti Devi Law College at Rewari Panipat Legal care and Support Centre Established in Geeta Institute of Law at Panipat Kurukshetra Legal care and Support Centre Established 1.Department of Law Kurukshetra University at Kurukshetra 2.Institute of Law, Kurukshetra University, Kurukshetra Hisar Legal care and Support Centre Established 1.Chhaju Ram Law College at Hisar 2. Agriculture University 3.Guru Jameshwar University 4. Govt. PG College, Hisar. Faridabad Legal care and Support Centre Established 1. B.S.Anangpuria Institution of Law College at Faridabad 2. Institute of Law & Research, Jasana, Tigaon Road at Faridabad Sonepat Legal care and Support Centre Established 1.B.P.S. Mahila Vishwa Vidyalaya College at Khanpur Kalan Dist. Sonepat 2. O.P. Jindal Global University at Sonepat Sirsa Legal care and Support Centre Established 1.Lala Hansraj Phutela College of Law at Sirsa 2. National College Sirsa. 3. C.M.K.College, Sirsa. 4. Chaudhary Devi Lal University at Sirsa Ambala Legal care and Support Centre Established 1. Department of Law M.M. University at Mullana Dist Ambala 2. Legal aid Clinic Established in Lala Ami Chand Monga Memorial College of Law VPO Ugala, District Ambala Gurgaon Legal care and Support Centre Established in of Law at Institute of law and Management Studies Gurgaon Rohtak 1. Legal care and Support Centre Established in Maharishi Dayanand University at Rohtak 2. Legal care and Support Centre Established in Chhotu Ram Institute of Law at Rohtak 3. Legal care and Support Centre Established in Vaish College of Law at Rohtak 4. Legal care and Support Centre in SBS College of Law, Rohtak. Narnaul Legal care and Support Centre Established in Central University of Haryana at Narnaul gfj;k.kk jkT; fof/kd lsok izkf/kdj.k bfULVVw’kuy IykV uEcj 9] lSDVj-14] iapdqyk bZ&esy % [email protected] oSc lkbZV % www.hslsa.nic.in